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dc.contributor.authorAbel, GA
dc.contributor.authorMendonca, SC
dc.contributor.authorMcPhail, S
dc.contributor.authorZhou, Y
dc.contributor.authorElliss-Brookes, L
dc.contributor.authorLyratzopoulos, G
dc.date.accessioned2019-02-08T11:41:17Z
dc.date.issued2017-05-25
dc.description.abstractBackground: Emergency diagnosis of cancer is common and aetiologically complex. The proportion of emergency presenters who have consulted previously with relevant symptoms is uncertain. Aim To examine how many patients with cancer, who were diagnosed as emergencies, have had previous primary care consultations with relevant symptoms; and among those, to examine how many had multiple consultations. Design and setting Secondary analysis of patient survey data from the 2010 English Cancer Patient Experience Survey (CPES), previously linked to populationbased data on diagnostic route. Method For emergency presenters with 18 different cancers, associations were examined for two outcomes (prior GP consultation status; and 'three or more consultations' among prior consultees) using logistic regression. Results Among 4647 emergency presenters, 1349 (29%) reported no prior consultations, being more common in males (32% versus 25% in females, P<0.001), older (44% in ≥85 versus 30% in 65-74-year-olds, P<0.001), and the most deprived (35% versus 25% least deprived, P = 0.001) patients; and highest/lowest for patients with brain cancer (46%) and mesothelioma (13%), respectively (P<0.001 for overall variation by cancer site). Among 3298 emergency presenters with prior consultations, 1356 (41%) had three or more consultations, which were more likely in females (P<0.001), younger (P<0.001), and non-white patients (P = 0.017) and those with multiple myeloma, and least likely for patients with leukaemia (P<0.001). Conclusion Contrary to suggestions that emergency presentations represent missed diagnoses, about one-third of emergency presenters (particularly those in older and more deprived groups) have no prior GP consultations. Furthermore, only about one-third report multiple (three or more) consultations, which are more likely in 'harderto- suspect' groups.en_GB
dc.description.sponsorshipCancer Research UKen_GB
dc.identifier.citationVol. 67 (659), pp. e377 - e387en_GB
dc.identifier.doi10.3399/bjgp17X690869
dc.identifier.grantnumberA18180en_GB
dc.identifier.urihttp://hdl.handle.net/10871/35848
dc.language.isoenen_GB
dc.publisherRoyal College of General Practitionersen_GB
dc.rights©British Journal of General Practice. This article is Open Access: CC BY 4.0 license (http://creativecommons.org/ licenses/by/4.0/).en_GB
dc.subjectcanceren_GB
dc.subjectdiagnosisen_GB
dc.subjectemergencyen_GB
dc.subjectopportunitiesen_GB
dc.subjectprimary careen_GB
dc.titleEmergency diagnosis of cancer and previous general practice consultations: Insights from linked patient survey dataen_GB
dc.typeArticleen_GB
dc.date.available2019-02-08T11:41:17Z
dc.identifier.issn0960-1643
dc.descriptionThis is the final published version. Available from the Royal College of General Practitioners via the DOI in this record.en_GB
dc.identifier.journalBritish Journal of General Practiceen_GB
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_GB
dcterms.dateAccepted2017-01-12
rioxxterms.versionVoRen_GB
rioxxterms.licenseref.startdate2017-01-12
rioxxterms.typeJournal Article/Reviewen_GB
refterms.dateFCD2019-02-08T11:37:24Z
refterms.versionFCDVoR
refterms.dateFOA2019-02-08T11:41:20Z
refterms.panelAen_GB
refterms.depositExceptionpublishedGoldOA


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©British Journal of General Practice. This article is Open Access: CC BY 4.0
license (http://creativecommons.org/
licenses/by/4.0/).
Except where otherwise noted, this item's licence is described as ©British Journal of General Practice. This article is Open Access: CC BY 4.0 license (http://creativecommons.org/ licenses/by/4.0/).