Pathways to myeloproliferative neoplasm presentation and time to diagnosis: results from a cross-sectional study

Background: Early cancer recognition is key to improving patient outcomes. Diagnosis is often delayed in patients with myeloproliferative neoplasms (MPNs), putting them at risk of thromboembolic events and other complications pre-diagnosis. A clear understanding of the barriers to presentation and...

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Main Authors: Emma-Louise Tarburn, Lisa Iversen, Charlotte Robertson, Charlene McShane, Andrew Duncombe, Mary-Frances McMullin, Claire Harrison, Ruben Mesa, Lesley A Anderson
Format: Article
Language:English
Published: Royal College of General Practitioners 2025-04-01
Series:BJGP Open
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Online Access:https://bjgpopen.org/content/9/1/BJGPO.2024.0068
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author Emma-Louise Tarburn
Lisa Iversen
Charlotte Robertson
Charlene McShane
Andrew Duncombe
Mary-Frances McMullin
Claire Harrison
Ruben Mesa
Lesley A Anderson
author_facet Emma-Louise Tarburn
Lisa Iversen
Charlotte Robertson
Charlene McShane
Andrew Duncombe
Mary-Frances McMullin
Claire Harrison
Ruben Mesa
Lesley A Anderson
author_sort Emma-Louise Tarburn
collection DOAJ
description Background: Early cancer recognition is key to improving patient outcomes. Diagnosis is often delayed in patients with myeloproliferative neoplasms (MPNs), putting them at risk of thromboembolic events and other complications pre-diagnosis. A clear understanding of the barriers to presentation and diagnosis is required. Aim: To explore barriers and factors influencing delayed presentation and diagnosis of MPNs. Design & setting: A cross-sectional study of patients with MPN within the UK and the Republic of Ireland. Method: An online cross-sectional survey of patients with MPN was undertaken. Symptoms and factors influencing patient and GP delay were examined. Adjusted odds ratios (aORs) were calculated to explore the relationship between these factors and patient and GP delay. Results: Most (80.2%) of the 620 patients completing the survey reported symptomatic presentation. The most common symptoms associated with patient delay were pruritus (aOR 1.89, 95% confidence interval [CI] = 1.19 to 3.01), headaches (aOR 1.86, 95% CI = 1.13 to 2.82), and concentration difficulties (aOR 1.75, 95% CI = 1.12 to 2.76). Attributing symptoms to ageing (aOR 1.92, 95% CI = 1.19 to 3.11) and not wanting to burden the GP (2.04, 95% CI = 1.24 to 3.39) were significantly associated with patient delay. Those reporting >3 blood cancer warning signs were more likely to experience GP delay than those experiencing fewer (aOR 3.26, 95% CI = 1.75 to 6.29), and lack of relational continuity of GP care was significantly associated with GP delay (aOR 3.41, 95% CI = 1.65 to 7.28). Conclusion: Debunking misconceptions around ageing, encouraging timely communication with GPs, and improving relational continuity of GP care could assist in reducing diagnostic delays, prevent potentially fatal disease complications, and ultimately improve outcomes for patients with MPN.
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spelling doaj-art-588ecacd78fa4e87ba20f5f12ad8dd4d2025-08-20T03:53:38ZengRoyal College of General PractitionersBJGP Open2398-37952025-04-019110.3399/BJGPO.2024.0068Pathways to myeloproliferative neoplasm presentation and time to diagnosis: results from a cross-sectional studyEmma-Louise Tarburn0https://orcid.org/0000-0002-6203-5685Lisa Iversen1Charlotte Robertson2Charlene McShane3Andrew Duncombe4Mary-Frances McMullin5Claire Harrison6Ruben Mesa7Lesley A Anderson8Aberdeen Centre for Health Data Science, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UKSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UKHaematology Department, Aberdeen Royal Infirmary, Aberdeen, UKCentre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UKHaematology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UKCentre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UKHaematology Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UKAtrium Health Levine Cancer Institute, Charlotte, NC, USAberdeen Centre for Health Data Science, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UKBackground: Early cancer recognition is key to improving patient outcomes. Diagnosis is often delayed in patients with myeloproliferative neoplasms (MPNs), putting them at risk of thromboembolic events and other complications pre-diagnosis. A clear understanding of the barriers to presentation and diagnosis is required. Aim: To explore barriers and factors influencing delayed presentation and diagnosis of MPNs. Design & setting: A cross-sectional study of patients with MPN within the UK and the Republic of Ireland. Method: An online cross-sectional survey of patients with MPN was undertaken. Symptoms and factors influencing patient and GP delay were examined. Adjusted odds ratios (aORs) were calculated to explore the relationship between these factors and patient and GP delay. Results: Most (80.2%) of the 620 patients completing the survey reported symptomatic presentation. The most common symptoms associated with patient delay were pruritus (aOR 1.89, 95% confidence interval [CI] = 1.19 to 3.01), headaches (aOR 1.86, 95% CI = 1.13 to 2.82), and concentration difficulties (aOR 1.75, 95% CI = 1.12 to 2.76). Attributing symptoms to ageing (aOR 1.92, 95% CI = 1.19 to 3.11) and not wanting to burden the GP (2.04, 95% CI = 1.24 to 3.39) were significantly associated with patient delay. Those reporting >3 blood cancer warning signs were more likely to experience GP delay than those experiencing fewer (aOR 3.26, 95% CI = 1.75 to 6.29), and lack of relational continuity of GP care was significantly associated with GP delay (aOR 3.41, 95% CI = 1.65 to 7.28). Conclusion: Debunking misconceptions around ageing, encouraging timely communication with GPs, and improving relational continuity of GP care could assist in reducing diagnostic delays, prevent potentially fatal disease complications, and ultimately improve outcomes for patients with MPN.https://bjgpopen.org/content/9/1/BJGPO.2024.0068cancerneoplasmsdiagnosisgeneral practice
spellingShingle Emma-Louise Tarburn
Lisa Iversen
Charlotte Robertson
Charlene McShane
Andrew Duncombe
Mary-Frances McMullin
Claire Harrison
Ruben Mesa
Lesley A Anderson
Pathways to myeloproliferative neoplasm presentation and time to diagnosis: results from a cross-sectional study
BJGP Open
cancer
neoplasms
diagnosis
general practice
title Pathways to myeloproliferative neoplasm presentation and time to diagnosis: results from a cross-sectional study
title_full Pathways to myeloproliferative neoplasm presentation and time to diagnosis: results from a cross-sectional study
title_fullStr Pathways to myeloproliferative neoplasm presentation and time to diagnosis: results from a cross-sectional study
title_full_unstemmed Pathways to myeloproliferative neoplasm presentation and time to diagnosis: results from a cross-sectional study
title_short Pathways to myeloproliferative neoplasm presentation and time to diagnosis: results from a cross-sectional study
title_sort pathways to myeloproliferative neoplasm presentation and time to diagnosis results from a cross sectional study
topic cancer
neoplasms
diagnosis
general practice
url https://bjgpopen.org/content/9/1/BJGPO.2024.0068
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