%0 Journal Article %A Henry Jensen %A Marie Louise Tørring %A Morten Fenger-Grøn %A Frede Olesen %A Jens Overgaard %A Peter Vedsted %T Tumour stage and implementation of standardised cancer patient pathways: a comparative cohort study %D 2016 %R 10.3399/bjgp16X684805 %J British Journal of General Practice %P e434-e443 %V 66 %N 647 %X Background Some European countries have introduced standardised cancer patient pathways (CPPs), including urgent referrals, with the aim of diagnosing cancer at an earlier stage. This is despite a lack of evidence, particularly in patients with symptomatic cancer diagnosed via general practice.Aim To compare tumour stages in patients with incident cancer diagnosed via general practice before, during, and after CPP implementation in Denmark in 2008–2009.Design and setting A comparative cohort study of data from GPs and registries on patients with incident cancer listed with a GP before (n = 1420), during (n = 5272), and after (n = 2988) CPP implementation.Method χ2 test was used to compare stage distributions and logistic regression to estimate odds ratios (OR) of having local cancer after versus before CPP implementation.Results Distribution of tumour stages did not differ statistically significantly across time (P = 0.494) or between CPP use (P = 0.202). For all cancers combined, the OR of having local cancer after CPP implementation was 0.88 (95% confidence interval [CI] = 0.73 to 1.06) compared with before. For CPP-referred patients, the OR of having local cancer was 0.77 (95% CI = 0.62 to 0.94) compared with all patients before CPP implementation; the corresponding OR for non-CPP-referred patients was 0.96 (95% CI = 0.80 to 1.14).Conclusion No clear tendencies were observed confirming earlier detection of cancer after rather than before CPP implementation. CPP-referred patients had lower odds of having local cancer after CPP implementation than all patients before CPP implementation; this could be because the GPs refer patients who are ‘more ill’ as urgent referrals. %U https://bjgp.org/content/bjgp/66/647/e434.full.pdf