Not visiting the GP and the risk of cancer: what are the possible implications for research, policy and practice?

doi:10.1002/ijc.31033

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…A natural response to the increased mortality in customary non-attenders (Jensen et al, 2017) could be to consider strategies aiming to increase the attendance in primary care (Sheringham, 2017). However, such strategies would also raise some questions.…”

Section: Interpretation and Implications For Cancer Diagnosismentioning

confidence: 99%

“…This is intuitively reasonable as nonattendance and frequent attendance are opposite extremes of attendance rates in general practice. Although more focus on high use of resources and poor prognosis among frequent attenders in general practice is needed (Dinkel et al, 2016;Ferrari et al, 2008;George & Rubin, 2003;Gili et al, 2011;Hauswaldt et al, 2012;Jørgensen et al, 2016;Patel et al, 2015;Smits et al, 2009;Vedsted & Olesen, 2005), the risk of poor prognosis among customary nonattenders should also be considered (Sheringham, 2017;Wolinsky et al, 2010). This is especially important because non-attenders have worse prognosis than frequent attenders after a diagnosis of cancer, even when accounting for higher comorbidity in frequent attenders (Jensen et al, 2017).…”

Section: Interpretation and Implications For Cancer Diagnosismentioning

confidence: 99%

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Characteristics of customary non‐attenders in general practice who are diagnosed with cancer: A cross‐sectional study in Denmark

2019

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Objective This study aimed to explore individual and structural factors in patients with cancer and their potential association with customary non‐attendance in general practice. Materials and methods We conducted a population‐based cross‐sectional study of all patients aged 50–89 years who were diagnosed with an incident cancer in 2009–2013 in Denmark. We investigated associations between being a customary non‐attender (defined as having no consultations in general practice in the 19–36 months before diagnosis) and selected patient‐related factors (demography, socioeconomic status), health‐related factors (multimorbidity) and structural factors (urbanisation degree, list size of general practice and use of out‐of‐hours services) using logistic regression. Results A total of 123,943 cancer patients were included; 11,567 (9.3%) of these were non‐attenders. Non‐attendance was associated with being more than 70 years of age, being single, having short or long education and being financially affluent. Non‐attendance was rarely seen in cancer patients with (multi)morbidity, in individuals living in an area with 2,000–99,999 inhabitants and in individuals having contact with the out‐of‐hours services. Conclusion Specific groups of cancer patients were more often customary non‐attenders in general practice. General practice may need to reach out more directly to these patients to ensure more timely cancer diagnosis.

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Section: Interpretation and Implications For Cancer Diagnosismentioning

confidence: 99%

Section: Interpretation and Implications For Cancer Diagnosismentioning

confidence: 99%

Characteristics of customary non‐attenders in general practice who are diagnosed with cancer: A cross‐sectional study in Denmark

2019

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Association between GPs’ suspicion of cancer and patients’ usual consultation pattern in primary care: a cross-sectional study

et al. 2019

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BackgroundPatients who rarely consult a GP in the 19–36 months before a cancer diagnosis have more advanced cancer at diagnosis and a worse prognosis. To ensure more timely diagnosis of cancer, the GP should suspect cancer as early as possible.AimTo investigate the GP’s suspicion of cancer according to the patient with cancer’s usual consultation pattern in general practice.Design and settingA cross-sectional study based on survey data from general practice of 3985 Danish patients diagnosed with cancer from May 2010 to August 2010, and linked to national register data.MethodUsing logistic regression analysis with restricted cubic splines, the odds ratio (OR) of the GP to suspect cancer as a function of the patient’s number of face-to-face consultations with the GP in the 19–36 months before a cancer diagnosis was estimated.ResultsGPs’ cancer suspicion decreased with higher usual consultation frequency in general practice. A significant decreasing trend in ORs for cancer suspicion was seen across usual consultation categories overall (P<0.001) and for each sex (males: P<0.05; females: P<0.05). GPs’ cancer suspicion was lower in patients aged <55 years in both rare and frequent attenders compared with average attenders.ConclusionGPs suspect cancer more often in rare attenders ≥55 years. GPs’ cancer suspicion was lower in younger patients (<55 years), in both rare and frequent attenders. GPs should be aware of possible missed opportunities for cancer diagnosis in young attenders and use safety netting to reduce the risk of missing a cancer diagnosis.

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Not visiting the GP and the risk of cancer: what are the possible implications for research, policy and practice?

Cited by 2 publications

References 8 publications

Characteristics of customary non‐attenders in general practice who are diagnosed with cancer: A cross‐sectional study in Denmark

Characteristics of customary non‐attenders in general practice who are diagnosed with cancer: A cross‐sectional study in Denmark

Association between GPs’ suspicion of cancer and patients’ usual consultation pattern in primary care: a cross-sectional study

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