Programme no. 333-OP
General practice consultations, diagnostic investigations and prescriptions in the years preceding a lung cancer diagnosis.
Louise Mahncke Guldbrandt*1, Peter Vedsted2, Henrik Møller3
1Research unit for General Practice,School of Public Health,Aarhus,Denmark, 2Research unit for General Practice,School of Public Health,Aarhus,Denmark, 3Research unit for General Practice,School of Public Health,Aarhus,Denmark;King's College,London,United Kingdom
* = Presenting author
Objectives: The aim of this project is to describe the prediagnostic activities of lung cancer patients in the year prior to diagnosis by investigating the numbers and timing of consultations, lung function tests, X-rays and medicines (COPD medicine, steroids and antibiotics) among lung cancer patients and a comparison group.
Background: Lung cancer is the most common course of cancer death in the industrialised world. Lung cancer patients in Denmark have inferior cancer survival rates compared to patients from other comparable European countries. This may be explained by later diagnosis of lung cancer in Denmark. It is possible that the survival deficit in Denmark may relate to processes of cancer awareness and diagnostic activity at the level of primary care. Most lung cancer patients present with symptoms to the general practitioner (GP) in the months before diagnosis. These symptoms and signs can mimic common lung diseases such as COPD. In this phase, when the patient is seen by the GP, it is thought to be an opportunity for earlier diagnosis of lung cancer, but little is known about the clinical trajectory and specific diagnostic patterns for these patients in primary care.
Results: The results are not yet available, but will be presented at the conference.
Material/Methods: The study includes all patients diagnosed with incident lung cancer (ICD 10 C34) in a recent 10-year period 2004-2013 (approximately 40.000 cases) from the Danish Cancer Registry and the Danish Lung Cancer Register. Ten sex and age-matched controls are selected among persons who where patients in the same practice as the case. We will make use of valid Danish registers for outcomes such as consultation and lung function test, X-rays and medicines.
Conclusion: This study will provide new knowledge about patterns in the use of primary health care services preceding a lung cancer diagnosis. These patterns can help optimising the diagnostic investigations for lung cancer in general practice and subsequently lead to earlier diagnosis and better prognosis.
Points for discussion: How will the diagnostic activity influence early diagnosis of cancer in primary care and what are the methodological challenges in how to measure activity in primary care?