Reimes Naomi, Bailey Sarah Er, Post Jasmin B, Kuiper Josephina G, van Nieuwenhuizen Benjamin P, Overbeek Jetty A, Willems Stefan M, Takes Robert P
PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.
University of Exeter, College House, St. Luke's Campus, Exeter, UK.
Cancer Epidemiol. 2025 Aug;97:102865. doi: 10.1016/j.canep.2025.102865. Epub 2025 Jun 16.
There are currently no data available on the referral landscape of head and neck cancer (HNC) patients from first visit to a general practitioner (GP) to diagnosis in the Netherlands. Since primary care is a key setting to reduce time to diagnosis (TTD), this study aimed to describe the healthcare pathway of HNC patients from first GP visit to diagnosis.
This study was a population-based case-control study among patients with HNC matched to a non-HNC control group.
The data collection period was between 2013 and 2020, the setting was in the Netherlands.
Patient and tumor characteristics were assessed at index date. The healthcare pathway between start date and index date was assessed, as well as TTD for cases, which was stratified by patient and tumor characteristics.
The final study population consisted of 9565 persons, of which 1913 HNC patients and 7652 matched non-HNC controls. Cases were most often male (67 %), median age was 66 years. HNC patients had more often a smoking and drinking history compared to controls (p < 0.0001). Cases had more GP visits, received more medication, were ordered more laboratory tests and had more referrals to a specialist, compared to controls (all p < 0.05). The overall mean (±standard deviation) TTD was 43.0 (±34.3) weeks, and was affected by gender, tumor location, and number of GP visits.
This is the first study that reported the demographics and healthcare use from first GP visit to diagnosis in the Netherlands. Future research should focus on identifying opportunities for earlier diagnosis.
目前在荷兰，尚无关于头颈癌（HNC）患者从首次就诊于全科医生（GP）到确诊这一转诊情况的数据。由于初级保健是缩短诊断时间（TTD）的关键环节，本研究旨在描述HNC患者从首次就诊于全科医生到确诊的医疗路径。
本研究是一项基于人群的病例对照研究，研究对象为HNC患者，并与非HNC对照组进行匹配。
数据收集期为2013年至2020年，研究背景为荷兰。
在索引日期评估患者和肿瘤特征。评估从开始日期到索引日期的医疗路径，以及病例的TTD，并按患者和肿瘤特征进行分层。
最终研究人群包括9565人，其中1913例HNC患者和7652例匹配的非HNC对照组。病例组男性居多（67%），中位年龄为66岁。与对照组相比，HNC患者吸烟和饮酒史更为常见（p<0.0001）。与对照组相比，病例组看全科医生的次数更多、用药更多、接受的实验室检查更多，转诊至专科医生的次数也更多（所有p<0.05）。总体平均（±标准差）TTD为43.0（±34.3）周，且受性别、肿瘤位置和看全科医生次数的影响。
这是第一项报告荷兰从首次就诊于全科医生到确诊的人口统计学和医疗利用情况的研究。未来的研究应侧重于确定早期诊断的机会。
