Abstract
Background: General practitioners (GPs) may detect cancer recurrences between specialised visits or after completed follow-up. There is limited evidence on diagnostic routes to detecting cancer recurrence. Aim: To examine the level of GP involvement in cancer recurrence detection, and to assess the time from the index consultation in general practice to a cancer recurrence diagnosis (diagnostic interval). Design and Setting: Retrospective cohort study linking survey data from 667 Danish general practices with national register data. Method: Patients with a recurrence diagnosed between 1 January 2022 and 31 May 2024 of seven cancer types were included. The patients’ GPs provided details on how the recurrence was detected. Results: The GP survey response rate was 48%. Of 1,081 patients with recurrence, 478 (44%) first presented signs or symptoms of recurrence in general practice. The recurrence was diagnosed during active specialised follow-up in 758 patients (70%), and after completed follow-up in 291 patients (27%). The diagnostic pathway for detection of recurrence was initiated in general practice for 369 patients (34%): 243 (66%) following symptomatic presentations, and 118 (32%) based on incidental, asymptomatic presentations. For patients with general practice-initiated diagnostic pathways, the 50th / 90th percentile of the diagnostic interval was 48 / 251 days for symptomatic presentations and 34 / 102 days for asymptomatic presentations. Conclusions: Four in ten patients with cancer recurrence had their first point of contact in general practice. However, significant delays were observed. Improving detection pathways for cancer recurrence in general practice may benefit survivors across cancer types.
- Received March 14, 2025.
- Accepted June 8, 2025.
- Copyright © 2025, The Authors
