ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2011
Are the serious problems in cancer survival partly rooted in gatekeeper principles? An ecologic study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 94 papers, 7 of them syntheses that pooled it.
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Who cites it
94 citing papers in PubMed, 7 syntheses or guidelines pooled it, 157 citations in OpenAlex.
- Cancer diagnostic tools to aid decision-making in primary care: mixed-methods systematic reviews and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2020Pooled it
- Primary medical care continuity and patient mortality: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- Decision support tools to improve cancer diagnostic decision making in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Pooled it
- Impact of GP gatekeeping on quality of care, and health outcomes, use, and expenditure: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Pooled it
- Pooled it
- Lung cancer in symptomatic patients presenting in primary care: a systematic review of risk prediction tools.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Pooled it
- Pooled it
- A geographical cluster randomised stepped wedge study of continuing medical education and cancer diagnosis in general practice.Implementation science : IS · 2014Trial
- Effect of adding a diagnostic aid to best practice to manage suspicious pigmented lesions in primary care: randomised controlled trial.BMJ (Clinical research ed.) · 2012Trial
- Interventions to Improve Timely Detection and Diagnosis of Cancer Among the Adult Population: A Scoping Review.Healthcare (Basel, Switzerland) · 2026Review
- Time Intervals in the Pathway to Diagnosis of Patients with Cancer.Nursing reports (Pavia, Italy) · 2025Article
- Comparative study of lung cancer care and survival outcomes across the Nordic countries.Acta oncologica (Stockholm, Sweden) · 2025Article
- Mapping intellectual structure and research hotspots of cancer studies in primary health care: A machine-learning-based analysis.Medicine · 2025Article
- Evaluation of the German living guideline "Protection against the Overuse and Underuse of Health Care" - an online survey among German GPs.BMC primary care · 2024Article
- Gatekeeping or Provider Choice for Sustainable Health Systems? A Literature Review on Their Impact on Efficiency, Access, and Quality of Services.Journal of market access & health policy · 2024Review
- Differences in the referral process from general practice to resident specialists in gynaecology depending on density of specialists and patients' socioeconomic status.Scandinavian journal of primary health care · 2023Article
- Factors affecting patient decisions to undergo testing for cancer symptoms: an exploratory qualitative study in Australian general practice.BJGP open · 2023Article
- Danish general practitioners as gatekeepers for gynaecological patients in regions with different density of resident specialists in gynaecology: in which situations and to whom do they refer? A cross-sectional study.Scandinavian journal of primary health care · 2023Article
- Geographic variation in referral practices for patients with suspected head and neck cancer: A survey of general practitioners using a clinical vignette.The Australian journal of rural health · 2022Article
- Prehospital care for ovarian cancer in Catalonia: could we do better in primary care? Retrospective cohort study.BMJ open · 2022Article
34 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is puzzling to note that British and Danish citizens have a poorer cancer prognosis than citizens from other countries, and this study hypothesises that their low cancer survival could be partly rooted in the gatekeeper function undertaken by general practice in these two countries.
aimTo test the association between principles of gatekeeper systems and cancer survival. DESIGN AND
settingAn ecologic study with data from EUROCARE-4 and primary care structure.
methodThis hypothesis was tested in an ecologic study on the association between three principles of gatekeeper systems and cancer survival in 19 European countries for which valid and full data were available.
resultsIt was found that healthcare systems with a gatekeeper system do have a significantly lower 1-year relative cancer survival than systems without such gatekeeper functions.
conclusionThe possible mechanisms behind this finding are discussed, and while all the positive aspects of gatekeeping are recognised, it is strongly recommended that further research be conducted to confirm or reject the study hypothesis on this possible serious adverse effect of gatekeeping.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.