Colon cancer diagnosed in patients with non-specific symptoms - comparisons between diagnostic paradigms
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Colon cancer diagnosed in patients with non-specific symptoms - comparisons between diagnostic paradigms. / Damhus, Christina Sadolin; Siersma, Volkert; Birkmose, Anna Rubach; Stovring, Henrik; Dalton, Susanne Oksbjerg; Brodersen, John Brandt.
In: Acta Oncologica, Vol. 62, No. 3, 2023, p. 272-280.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Colon cancer diagnosed in patients with non-specific symptoms - comparisons between diagnostic paradigms
AU - Damhus, Christina Sadolin
AU - Siersma, Volkert
AU - Birkmose, Anna Rubach
AU - Stovring, Henrik
AU - Dalton, Susanne Oksbjerg
AU - Brodersen, John Brandt
PY - 2023
Y1 - 2023
N2 - Background In Denmark, the Cancer Patient Pathway for Non-Specific Signs and Symptoms (NSSC-CPP) has been implemented with variations: in some areas, general practitioners (GPs) do the initial diagnostic work-up (GP paradigm); in other areas, patients are referred directly to the hospital (hospital paradigm). There is no evidence to suggest the most beneficial organisation. Therefore, this study aims to compare the occurrence of colon cancer and the risk of non-localised cancer stage between the GP and hospital paradigms.Material and Methods In this registry-based case-control study, we applied multivariable binary logistic regression models to estimate the odds ratios (OR) of colon cancer and non-localised stage associated with the GP paradigm and hospital paradigm. All cases and controls were assigned to a paradigm based on their diagnostic activity (CT scan or CPP) six months before the index date. As not all CT scans in the control group were part of the cancer work-up as a sensitivity analysis, we investigated the impact of varying the fraction of these, which were randomly removed using a bootstrap approach for inference.Results The GP paradigm was more likely to result in a cancer diagnosis than the hospital paradigm; ORs ranged from 1.91-3.15 considering different fractions of CT scans as part of cancer work-up. No difference was found in the cancer stage between the two paradigms; ORs ranged from 1.08-1.10 and were not statistically significant.Conclusion Patients in the GP paradigm were diagnosed with colon cancer more often, but we cannot conclude that the distribution of respectively localised or non-localised extent of disease is different from that of patients in the hospital paradigm.
AB - Background In Denmark, the Cancer Patient Pathway for Non-Specific Signs and Symptoms (NSSC-CPP) has been implemented with variations: in some areas, general practitioners (GPs) do the initial diagnostic work-up (GP paradigm); in other areas, patients are referred directly to the hospital (hospital paradigm). There is no evidence to suggest the most beneficial organisation. Therefore, this study aims to compare the occurrence of colon cancer and the risk of non-localised cancer stage between the GP and hospital paradigms.Material and Methods In this registry-based case-control study, we applied multivariable binary logistic regression models to estimate the odds ratios (OR) of colon cancer and non-localised stage associated with the GP paradigm and hospital paradigm. All cases and controls were assigned to a paradigm based on their diagnostic activity (CT scan or CPP) six months before the index date. As not all CT scans in the control group were part of the cancer work-up as a sensitivity analysis, we investigated the impact of varying the fraction of these, which were randomly removed using a bootstrap approach for inference.Results The GP paradigm was more likely to result in a cancer diagnosis than the hospital paradigm; ORs ranged from 1.91-3.15 considering different fractions of CT scans as part of cancer work-up. No difference was found in the cancer stage between the two paradigms; ORs ranged from 1.08-1.10 and were not statistically significant.Conclusion Patients in the GP paradigm were diagnosed with colon cancer more often, but we cannot conclude that the distribution of respectively localised or non-localised extent of disease is different from that of patients in the hospital paradigm.
KW - General practice
KW - signs and symptoms
KW - colon cancer
KW - cancer staging
KW - cancer patient pathways
KW - GUT FEELINGS
KW - DANISH
KW - CARE
U2 - 10.1080/0284186X.2023.2185910
DO - 10.1080/0284186X.2023.2185910
M3 - Journal article
C2 - 36897844
VL - 62
SP - 272
EP - 280
JO - Acta Oncologica
JF - Acta Oncologica
SN - 1100-1704
IS - 3
ER -
ID: 340684765