Risk of cancer and repeated urgent referral after negative investigation for cancer

Many countries have implemented cancer patient pathways (CPPs) for organ-specific cancers. The aim of this study was to estimate the proportion of patients who were referred to a second CPP, were diagnosed with cancer or died within 6 months after receiving a negative result from clinical investigation through an initial CPP. Data was collected historically from a Danish registry, identifying 109 998 patients. Of these patients, 0.6% received a cancer diagnosis, 2.3% died and 6.1% were referred to a second CPP within 6 months. 48.9% of the re-referrals in the gastrointestinal area (GI) were referred to a second CPP also in the GI area. Re-referral had a positive predictive value (PPV) of 4.4% to be diagnosed with cancer. The PPV of 4.4% indicates that some cancers may be missed in the diagnostic investigation through the first CPP and calls for consideration of how CPPs may best support the primary care diagnosis. Read the full article