Jensen Henry, Vedsted Peter, Møller Henrik
Research Centre for Cancer Diagnosis in Primary Care, Department of Public Health, Aarhus University, Denmark; Research Unit for General Practice & Section for General Practice, Department of Public Health, Aarhus University, Denmark.
Research Centre for Cancer Diagnosis in Primary Care, Department of Public Health, Aarhus University, Denmark; Research Unit for General Practice & Section for General Practice, Department of Public Health, Aarhus University, Denmark.
Cancer Epidemiol. 2018 Aug;55:142-148. doi: 10.1016/j.canep.2018.06.007. Epub 2018 Jun 28.
Cancer patients who usually consult the general practitioner (GP) rarely are generally diagnosed with more advanced stages of cancer. This subgroup of cancer patients may thus postpone relevant healthcare seeking.
We aimed to investigate the rates of daytime face-to-face consultations in general practice before a cancer diagnosis in patients with different categories of 'usual' consultation frequency.
We conducted a population-based comparative study using register data on all 123,934 first-time cancer patients aged 50-90 years who were diagnosed in 2009-2013 in Denmark. Usual consultation rates were based on number of consultations from 19 to 36 months before cancer diagnosis. We predicted the marginal monthly consultation rates for up to 18 months before diagnosis. These were based on the estimated (mean) rates of consultations with corresponding 95% confidence intervals (CIs), which were calculated by negative binomial regression analysis with robust variance estimation.
Patients with cancer began to increase their consultation frequency four to six months before their cancer diagnosis. The average monthly consultation rates varied slightly across usual consultation groups; rates were lowest among male 'frequent' consulters (0.28 (95% CI: 0.27;0.29)) and highest among female 'frequent' consulters (0.35 (95% CI: 0.34;0.37)). The additional number of consultations was 1-2 for all combinations of usual consultation frequency, sex, and cancer type (except for female breast cancer and 'average' consulters with lung or prostate cancer).
Patients with cancer begin to increase their consultation frequency in general practice before a cancer diagnosis independently of their usual consultation frequency.
通常咨询全科医生（GP）的癌症患者很少被诊断为癌症晚期。因此，这一亚组癌症患者可能会推迟寻求相关医疗服务。
我们旨在调查不同“通常”咨询频率类别的患者在癌症诊断前全科医疗中面对面日间咨询的比率。
我们利用丹麦2009 - 2013年确诊的所有123,934名年龄在50 - 90岁的首次癌症患者的登记数据进行了一项基于人群的比较研究。通常咨询率基于癌症诊断前19至36个月的咨询次数。我们预测了诊断前长达18个月的每月边际咨询率。这些比率基于估计的（平均）咨询率及其相应的95%置信区间（CI），通过稳健方差估计的负二项回归分析计算得出。
癌症患者在癌症诊断前四至六个月开始增加咨询频率。不同通常咨询组的平均每月咨询率略有差异；男性“频繁”咨询者的比率最低（0.28（95%CI：0.27；0.29）），女性“频繁”咨询者的比率最高（0.35（95%CI：0.34；0.37））。对于通常咨询频率、性别和癌症类型的所有组合，额外咨询次数为1 - 2次（女性乳腺癌以及肺癌或前列腺癌的“平均”咨询者除外）。
癌症患者在癌症诊断前开始增加在全科医疗中的咨询频率，这与他们通常的咨询频率无关。
