ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2016
Pre-referral GP consultations in patients subsequently diagnosed with rarer cancers: a study of patient-reported data.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Patients' experiences of the path to sarcoma diagnosis: a qualitative systematic review and thematic synthesis.BMJ open · 2026Pooled it
- A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022Pooled it
- Patient and carer perceived barriers to early presentation and diagnosis of lung cancer: a systematic review.BMC cancer · 2019Pooled it
- Observational
- Clinical Presentation and Tumour Burden in Head and Neck Sarcomas: Implications for Early Diagnosis and Referral.Cancers · 2026Article
- Quantifying diagnostic intervals and routes to diagnosis for children and young people with cancer in the UK (Childhood Cancer Diagnosis study, CCD): a population-based observational study.The Lancet regional health. Europe · 2025Article
- Diagnostic Delay in Soft Tissue Sarcomas: A Review.Cancers · 2025Review
- The Prediagnostic General Practitioners' Pathway of Gastrointestinal Stromal Tumor Patients: A Real-World Data Study.Cancers · 2025Article
- Global and regional disparities in access to specialist sarcoma services.Bone & joint open · 2025Article
- A UK population-based case-control study of blood tests before cancer diagnosis in patients with non-specific abdominal symptoms.British journal of cancer · 2025Article
- Diagnostic trajectories of patients with rare cancer in the Netherlands: results from a nationwide cross-sectional survey.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Clinical activity in general practice before sarcoma diagnosis: an Australian cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- A Prospective Observational Cohort Study for Newly Diagnosed Osteosarcoma Patients in the UK: ICONIC Study Initial Results.Cancers · 2024Article
- Understanding GPs' referral decisions for younger patients with symptoms of cancer: a qualitative interview study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Using online search activity for earlier detection of gynaecological malignancy.BMC public health · 2024Article
- Phenotypes and rates of cancer-relevant symptoms and tests in the year before cancer diagnosis in UK Biobank and CPRD Gold.PLOS digital health · 2023Article
- Current and Emerging Strategies for Tubo-Ovarian Cancer Diagnostics.Diagnostics (Basel, Switzerland) · 2023Review
- Patients' Experiences of a Sarcoma Diagnosis: A Process Mapping Exercise of Diagnostic Pathways.Cancers · 2023Article
- The Influence of Ethnicity on Survival from Malignant Primary Brain Tumours in England: A Population-Based Cohort Study.Cancers · 2023Article
- Associations of Symptom Clusters and Health Outcomes in Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
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Authors and funding
3 authors.
Funding
Abstract
backgroundSome patients with cancer experience multiple pre-diagnostic consultations in primary care, leading to longer time intervals to specialist investigations and diagnosis. Patients with rarer cancers are thought to be at higher risk of such events, but concrete evidence of this is lacking.
aimTo examine the frequency and predictors of repeat consultations with GPs in patients with rarer cancers. DESIGN AND
settingPatient-reported data on pre-referral consultations from three English national surveys of patients with cancer (2010, 2013, and 2014), pooled to maximise the sample size of rarer cancers.
methodThe authors examined the frequency and crude and adjusted odds ratios for ≥3 (versus 1-2) pre-referral consultations by age, sex, ethnicity, level of deprivation, and cancer diagnosis (38 diagnosis groups, including 12 rarer cancers without prior relevant evidence).
resultsAmong 7838 patients with 12 rarer cancers, crude proportions of patients with ≥3 pre-referral consultations ranged from >30.0% to 60.0% for patients with small intestine, bone sarcoma, liver, gallbladder, cancer of unknown primary, soft-tissue sarcoma, and ureteric cancer. The range was 15.0-30.0% for patients with oropharyngeal, anal, parotid, penile, and oral cancer. The overall proportion of responders with any cancer who had ≥3 consultations was 23.4%. Multivariable logistic regression indicated concordant patterns, with strong evidence for variation between rarer cancers (P <0.001).
conclusionPatients with rarer cancers experience pre-referral consultations at frequencies suggestive of middle-to-high diagnostic difficulty. The findings can guide the development of new diagnostic interventions and 'safety-netting' approaches for symptomatic presentations encountered in patients with rarer cancers.
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