References
RESEARCH ROUNDUP
Abstract
The prognosis for colorectal cancer (CRC) depends on stage at diagnosis, but although CRC screening programmes exist in many countries, the diagnoses of most CRC cases are based on symptom presentation, making it challenging for GPs.
In this questionnaire-based Danish two-year study of 187 general practices, Jarbøl et al (2024) explored CRC patients' diagnostic pathways by considering their first place of contact with the healthcare system; the influence of symptom presentations, sex and age on events in the diagnostic process; and the GPs' evaluation of the diagnostic processes.
Of 8,240 cancer patients, 1,032 (12.5%) were diagnosed with CRC. Of these, 65% had their first contact in general practice; 27% of those aged over 40 years who first presented in general practice were treated or referred on suspicion of another disease; 20% were diagnosed through screening; 10% diagnosed in hospital; and 5% diagnosed through the out-of-hours service. However, some 37% of CRC patients presented with non-specific symptoms, raising the chances of a GP advising watchful waiting. The GPs, note the authors, ‘assessed nearly one fifth of the diagnostic processes as poor’ and they conclude that most CRC patients are diagnosed with initial presentation in general practice, and that having non-specific symptoms is common and challenges timely diagnosis.
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