Georgios Lyratzopoulos|Richard D Neal|Josephine Barbiere|Gregory Rubin|Gary Abel
Variation in number of general practitioner consultations before hospital referral for cancer: findings from the 2010 National Cancer Patient Experience Survey in England
University of Cambridge|Bangor University|University of Cambridge|Durham University|University of Cambridge
information patient surveys help identify patient groups cancers greatest potential improvement experience timeliness cancer diagnosis aimed examine variation number prereferral consultations general practitioner patients different cancers sociodemographic characteristicswe analysed data 41299 patients 24 different cancers took part 2010 national cancer patient experience survey england examined variation number general practitioner consultations cancer symptoms hospital referral diagnose cancer logistic regression used identify independent predictors three prereferral consultations adjusting cancer type age sex deprivation quintile ethnic groupwe identified wide variation cancer types proportion patients visited general practitioner three times hospital referral 74 625 8408 breast cancer 101 113 1124 melanoma 413 193 467 pancreatic cancer 506 939 1854 multiple myeloma multivariable analysis patients rectal cancer reference group subsequent diagnosis multiple myeloma odds ratio 342 95 ci 301390 pancreatic cancer 235 191288 stomach cancer 196 165234 lung cancer 168 148190 likely three prereferral consultations conversely patients subsequent diagnosis breast cancer 019 017022 melanoma 034 027043 testicular cancer 047 033067 endometrial cancer 059 049071 likely referred hospital one two consultations probability three prereferral consultations greater young patients patients aged 1624 years vs 6574 years 212 95 ci 163275 p00001 ethnic minorities asian vs white 173 145208 p00001 black vs white 183 151223 p00001 women women vs men 128 121136 p00001 identified strong evidence interactions cancer type age group sex p00001 age ethnicity p00013 model including interactions showed particularly strong sex effect bladder cancer women vs men 231 95 ci 198269 apparent ethnic group differences young patients aged 1624 years whilst cancers without apparent age gradient testicular cancer mesotheliomaour findings could help prioritise stratify early diagnosis initiatives research focusing patients cancers sociodemographic characteristics largest potential improvementnone