Addressing delayed cancer diagnosis in primary care: Patterns of attendance and symptoms of teenagers and young adults seen in 3 general practices during 1 year


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Lorna Fern1, Christine Campbell2, Tim Eden3, Robert Grant4, Ian Lewis5, Una McLeod6, David Weller2, Jeremy Whelan1

1University College Hospitals, London, UK, 2University of Edinburgh, Edinburgh, UK, 3University of Manchester, Manchester, UK, 4St Brysdale Surgery, Fife, UK, 5University of Leeds, Leeds, UK, 6University of Glasgow, Glasgow, UK

Abstract

Addressing delayed cancer diagnosis in primary care: Patterns of attendance and symptoms of teenagers and young adults seen in 3 general practices during 1 year

Background

Delays in diagnosis in primary care for TYA with cancer are reported. It has been presumed for some time that TYA underutilise primary care services however, the normal pattern of GP attendance in TYA has not previously been described.

Aim

We set out to determine (a) how often TYA present (b) reasons for consultation and (c) how often potential oncological symptoms appear.

Method

GP attendance data was extracted from three practices for patients aged 15-24 years presenting between 1/10/06 – 30/9/07. Patient age, sex and reason for visit(s) were recorded. A coding system was employed to assign symptoms/reason for visit into four categories; A: presentations with no oncological significance;B: presentations which have some ‘potential oncological significance’; C: other clinical conditions; D:No symptom/clinical condition.

Results

The total list size of the three practices was 20,068; with 2,544 (12.7%) patients aged 15-24 years. During the 12 month period 1,686 TYA’s consulted at least once (66.3%), resulting in a total of 6,730 consultations. The numbers of patients consulting once, twice, three and four times or more were 475 (28.2%), 348 (20.6%), 239 (14.2%), and 624 (37.0%) respectively. Over three quarters of consultations involved symptoms with no oncological significance, 5,143 (76.4%), conversely the proportion of consultations involving symptoms with some oncological significance was 265 (3.9%).

Conclusion

This interim analysis demonstrates TYA commonly use GP services, however the frequency of symptoms with potential oncological significance is rare. Further research is needed to identify how GPs respond to symptoms of potential oncological significance.