PT  - JOURNAL ARTICLE
AU  - Henry Jensen
AU  - Camilla Hoffmann Merrild
AU  - Henrik Møller
AU  - Peter Vedsted
TI  - Association between GPs’ suspicion of cancer and patients’ usual consultation pattern in primary care: a cross-sectional study
AID  - 10.3399/bjgp19X700769
DP  - 2019 Feb 01
TA  - British Journal of General Practice
PG  - e80--e87
VI  - 69
IP  - 679
4099  - http://bjgp.org/content/69/679/e80.short
4100  - http://bjgp.org/content/69/679/e80.full
SO  - Br J Gen Pract2019 Feb 01; 69
AB  - Background Patients 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.Aim To investigate the GP’s suspicion of cancer according to the patient with cancer’s usual consultation pattern in general practice.Design and setting A 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.Method Using 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.Results GPs’ 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.Conclusion GPs 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.