Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK.
Information Services Division (ISD), NHS National Services Scotland, Edinburgh, UK.
Eur J Cancer Care (Engl). 2020 May;29(3):e13234. doi: 10.1111/ecc.13234. Epub 2020 Mar 10.
To characterize cancer diagnosis in Scottish primary care and draw comparisons with cancer diagnostic activity in England.
A national audit of cancer diagnosis was conducted in Scottish and English general practices. Participating GPs collected diagnostic pathway data on patients diagnosed in 2014 from medical records. Data were supplemented by linkage to national cancer registries. Analysis explored and compared patient characteristics, diagnostic intervals, and routes to diagnosis.
7.7% of all Scottish general practices in 2017 provided data on 2,014 cancer diagnoses. 71.5% of cases presented to GPs and 37.4% were referred using the "Urgent-Suspected Cancer" route. The median primary care interval was 5 days (IQR 0-23 days) and median diagnostic interval was 30 days (IQR 13-68). Both varied by cancer-site. Diagnostic intervals were longer in the most remote patients and those with more comorbidities. Scottish and English samples corresponded closely in key characteristics.
Most people diagnosed with cancer in Scotland present to a GP first. Most are referred and diagnosed quickly, with variations by cancer-site. Intervals were longest for the most remote patients. GPs in Scotland and England appear to perform equally but, in view of growing differences between health systems, future comparative audits may be informative.
描述苏格兰初级保健中的癌症诊断情况，并与英格兰的癌症诊断活动进行比较。
在苏格兰和英格兰的普通诊所进行了一项全国性的癌症诊断审计。参与的全科医生从病历中收集了 2014 年诊断的患者的诊断途径数据。数据通过与国家癌症登记处的链接进行补充。分析探讨并比较了患者特征、诊断间隔和诊断途径。
2017 年，苏格兰有 7.7%的普通诊所提供了 2014 年 2014 例癌症诊断的数据。71.5%的病例向全科医生就诊，37.4%的病例通过“紧急疑似癌症”途径转诊。初级保健间隔中位数为 5 天（IQR 0-23 天），诊断间隔中位数为 30 天（IQR 13-68 天）。两者都因癌症部位而异。诊断间隔在最偏远的患者和合并症较多的患者中更长。苏格兰和英国的样本在关键特征上非常匹配。
在苏格兰被诊断出癌症的大多数人首先向全科医生就诊。大多数人被迅速转诊和诊断，癌症部位不同，诊断间隔也不同。最偏远的患者的间隔时间最长。苏格兰和英格兰的全科医生似乎表现相当，但鉴于卫生系统之间日益扩大的差异，未来的比较审计可能会提供信息。
