Exploring colorectal cancer patients’ diagnostic pathways and general practitioners’ assessment of the diagnostic processes: a Danish survey study

Introduction Colorectal cancer (CRC) is among the most common cancers and the prognosis of CRC is highly dependent on stage at diagnosis. Although many cases are diagnosed swiftly, there is still room for improvement.Aim We aimed to explore CRC diagnostic pathways, encompassing (1) place of initial...

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Main Authors: Dorte E. Jarbøl, Sanne Rasmussen, Kirubakaran Balasubramaniam, Jesper Lykkegaard, Linda Juel Ahrenfeldt, Gitte B. Lauridsen, Peter Haastrup
Format: Article
Language:English
Published: Taylor & Francis Group 2025-04-01
Series:Scandinavian Journal of Primary Health Care
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Online Access:https://www.tandfonline.com/doi/10.1080/02813432.2024.2432376
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author Dorte E. Jarbøl
Sanne Rasmussen
Kirubakaran Balasubramaniam
Jesper Lykkegaard
Linda Juel Ahrenfeldt
Gitte B. Lauridsen
Peter Haastrup
author_facet Dorte E. Jarbøl
Sanne Rasmussen
Kirubakaran Balasubramaniam
Jesper Lykkegaard
Linda Juel Ahrenfeldt
Gitte B. Lauridsen
Peter Haastrup
author_sort Dorte E. Jarbøl
collection DOAJ
description Introduction Colorectal cancer (CRC) is among the most common cancers and the prognosis of CRC is highly dependent on stage at diagnosis. Although many cases are diagnosed swiftly, there is still room for improvement.Aim We aimed to explore CRC diagnostic pathways, encompassing (1) place of initial contact; (2) associations with symptom presentations, sex, and age with events in the diagnostic process and initial referrals and (3) the general practitioner’s (GP’s) evaluation of the diagnostic processes.Methods All GPs in North-, Central-, and Southern Denmark were invited to fill in questionnaires for their listed patients diagnosed with cancer during the past two years.Results Among 1,032 recorded CRC patients, 65% had their initial contact in general practice, 5% within the out-of hours service, 10% in the hospital, and 20% were diagnosed based on screening. A total of 27% of CRC patients over 40 who initially presented in general practice were treated or referred on suspicion of another disease first, and 9% were reported to have had hesitated in seeking medical attention. Some 37% presented solely non-specific symptoms, increasing the odds of the GP advising watchful waiting (OR 2.48; 95% CI 1.06–5.81), treating or referring on the suspicion of another illness first (OR 2.57; 95% CI 1.76–3.75), wait due to normal findings (OR 2.11; 95% CI 1.16–3.85), or referring to diagnostic imaging (OR 3.07; 95% CI 1.63–5.79). The GPs assessed nearly one fifth of the diagnostic processes as poor.Conclusion Most CRC patients are diagnosed with initial presentation in general practice. Having non-specific symptoms is common and challenges timely diagnosis.
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spelling doaj-art-2dc2b8ea5eb84128b9d483c7ab1eebdf2025-08-20T03:47:40ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242025-04-0143230331210.1080/02813432.2024.2432376Exploring colorectal cancer patients’ diagnostic pathways and general practitioners’ assessment of the diagnostic processes: a Danish survey studyDorte E. Jarbøl0Sanne Rasmussen1Kirubakaran Balasubramaniam2Jesper Lykkegaard3Linda Juel Ahrenfeldt4Gitte B. Lauridsen5Peter Haastrup6Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense M, DenmarkDepartment of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense M, DenmarkDepartment of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense M, DenmarkDepartment of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense M, DenmarkDepartment of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense M, DenmarkDepartment of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense M, DenmarkDepartment of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense M, DenmarkIntroduction Colorectal cancer (CRC) is among the most common cancers and the prognosis of CRC is highly dependent on stage at diagnosis. Although many cases are diagnosed swiftly, there is still room for improvement.Aim We aimed to explore CRC diagnostic pathways, encompassing (1) place of initial contact; (2) associations with symptom presentations, sex, and age with events in the diagnostic process and initial referrals and (3) the general practitioner’s (GP’s) evaluation of the diagnostic processes.Methods All GPs in North-, Central-, and Southern Denmark were invited to fill in questionnaires for their listed patients diagnosed with cancer during the past two years.Results Among 1,032 recorded CRC patients, 65% had their initial contact in general practice, 5% within the out-of hours service, 10% in the hospital, and 20% were diagnosed based on screening. A total of 27% of CRC patients over 40 who initially presented in general practice were treated or referred on suspicion of another disease first, and 9% were reported to have had hesitated in seeking medical attention. Some 37% presented solely non-specific symptoms, increasing the odds of the GP advising watchful waiting (OR 2.48; 95% CI 1.06–5.81), treating or referring on the suspicion of another illness first (OR 2.57; 95% CI 1.76–3.75), wait due to normal findings (OR 2.11; 95% CI 1.16–3.85), or referring to diagnostic imaging (OR 3.07; 95% CI 1.63–5.79). The GPs assessed nearly one fifth of the diagnostic processes as poor.Conclusion Most CRC patients are diagnosed with initial presentation in general practice. Having non-specific symptoms is common and challenges timely diagnosis.https://www.tandfonline.com/doi/10.1080/02813432.2024.2432376Colorectal cancerGeneral practiceDiagnosisEvaluationSymptoms
spellingShingle Dorte E. Jarbøl
Sanne Rasmussen
Kirubakaran Balasubramaniam
Jesper Lykkegaard
Linda Juel Ahrenfeldt
Gitte B. Lauridsen
Peter Haastrup
Exploring colorectal cancer patients’ diagnostic pathways and general practitioners’ assessment of the diagnostic processes: a Danish survey study
Scandinavian Journal of Primary Health Care
Colorectal cancer
General practice
Diagnosis
Evaluation
Symptoms
title Exploring colorectal cancer patients’ diagnostic pathways and general practitioners’ assessment of the diagnostic processes: a Danish survey study
title_full Exploring colorectal cancer patients’ diagnostic pathways and general practitioners’ assessment of the diagnostic processes: a Danish survey study
title_fullStr Exploring colorectal cancer patients’ diagnostic pathways and general practitioners’ assessment of the diagnostic processes: a Danish survey study
title_full_unstemmed Exploring colorectal cancer patients’ diagnostic pathways and general practitioners’ assessment of the diagnostic processes: a Danish survey study
title_short Exploring colorectal cancer patients’ diagnostic pathways and general practitioners’ assessment of the diagnostic processes: a Danish survey study
title_sort exploring colorectal cancer patients diagnostic pathways and general practitioners assessment of the diagnostic processes a danish survey study
topic Colorectal cancer
General practice
Diagnosis
Evaluation
Symptoms
url https://www.tandfonline.com/doi/10.1080/02813432.2024.2432376
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