Clinical features of patients with non- metastatic lung cancer in primary care

Late stage diagnosis is a contributing factor for the high mortality rates of lung cancer. This case-control study aimed to identify the prediagnostic features of non-metastatic lung cancer (nMLC) and to compare the clinical features in GPs’ chest X-ray referral letters with the clinical features (diagnostic codes) in medical records. 373 patients diagnosed with lung cancer (of which 132 had nMLC) and 1472 controls were identified from the Swedish Cancer Register and regional healthcare database. Clinical features with the highest odds ratio (OR) were vitamin B12 deficiency anemia, dyspnoea and chronic bronchitis. Clinical features that were GPs reason for requesting chest X-ray were almost 3 times more frequent in referral letters compared to the corresponding diagnostic codes used in medical records. From this study, patients with nMLC cannot be easily identified by symptoms. However, this study showed that referrals for chest X-ray from primary care resulted in a detection rate of 40% of patients with nMLC.
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