Diagnosing pancreatic cancer in general practice: a cross-sectional study on associations between suspicion of cancer, urgent referral and time to diagnosis

Pancreatic cancer is often diagnosed in late stages, and understanding the pathway to diagnosis may highlight areas for reducing delays in diagnoses. A Danish cross-sectional study identified 438 patients diagnosed with pancreatic cancer between 2010 and 2016 from the Danish National Patient Register. GPs who attended to these patients answered surveys about their experience with the diagnosis. The authors found that over 85% of pancreatic cancer patients first approached GPs with symptoms; we note that Denmark has a similar healthcare system to Australia, where GPs are essentially gatekeepers to further specialist services for the population. Cancer was suspected in only one-third of these pancreatic cancer patients in primary care, with 23% urgently referred to a Cancer Patient Pathway. This led to a shorter time to diagnosis. On the other hand, when GPs did not get a first impression of cancer, the probability of a delayed diagnosis increased significantly. GPs tended to suspect cancer in older patients (over 70 years old), those with high comorbidity, or those with higher education. Overall, the average diagnostic interval was just over a month. As GPs are crucial for cancer diagnoses in countries like Denmark and Australia, these findings suggest that GPs may benefit from increased access to diagnostic tools including ultrasound and endoscopy to assist with the pancreatic cancer symptoms which are often non-specific. Increased support in the form of continuing medical education may also assist GPs with further understanding aspects of clinical judgement in the first consultation and its importance in reducing time to diagnosis. Read the original article here.
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