ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2020
Association between use of urgent suspected cancer referral and mortality and stage at diagnosis: a 5-year national cohort study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022Pooled it
- Association between time-to-treatment and outcomes in non-small cell lung cancer: a systematic review.Thorax · 2022Pooled it
- Determinants of Physicians' Referrals for Suspected Cancer Given a Risk-Prediction Algorithm: Linking Signal Detection and Fuzzy Trace Theory.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
- Correlates of the Stage of Esophageal Cancer at Diagnosis Among Patients: A Mixed-Methods Cross-Sectional Study.Cancer management and research · 2026Article
- Assessing the impact of timely diagnosis on psychological outcomes and quality of life for cancer patients: A scoping review.PloS one · 2026Article
- Clinical Utility of Multicancer Detection in Symptomatic Patients: A Decision-Making Perspective.JCO precision oncology · 2025Article
- Patients' perceptions on reasons for self-referring to the emergency department shortly before a cancer diagnosis: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Performance of a national primary care chronic disease screening strategy in Chile: a mixed-methods analysis.BMC health services research · 2025Article
- Article
- Strengthening general practice will help improve longevity and could reduce health inequalities.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Achieving earlier diagnosis of symptomatic lung cancer.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- How GPs communicate the urgent suspected cancer referral pathway to patients: a qualitative study of GP-patient consultations.BJGP open · 2025Article
- GP referrals for suspected cancer in Ireland: protocol for a cross-sectional study (GRACCHUS).HRB open research · 2025Article
- 'ThinkCancer!': randomised feasibility trial of a novel practice-based early cancer diagnosis intervention.BJGP open · 2024Article
- Clinical decision-making on lung cancer investigations in primary care: a vignette study.BMJ open · 2024Article
- Learning from new colorectal cancers: a qualitative synthesis of significant event reports.BJGP open · 2024Article
- Transforming post pandemic cancer services.British journal of cancer · 2024Review
- Which patients with symptoms should be referred urgently for investigation of suspected cancer?BMJ oncology · 2024Article
- Priorities for implementation research on diagnosing cancer in primary care: a consensus process.BMC health services research · 2023Article
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Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThere is considerable variation between GP practices in England in their use of urgent referral pathways for suspected cancer.
aimTo determine the association between practice use of urgent referral and cancer stage at diagnosis and cancer patient mortality, for all cancers and the most common types of cancer (colorectal, lung, breast, and prostate). DESIGN AND
settingNational cohort study of 1.4 million patients diagnosed with cancer in England between 2011 and 2015.
methodThe cohort was stratified according to quintiles of urgent referral metrics. Cox proportional hazards regression was used to quantify risk of death, and logistic regression to calculate odds of late-stage (III/IV) versus early-stage (I/II) cancers in relation to referral quintiles and cancer type.
resultsCancer patients from the highest referring practices had a lower hazard of death (hazard ratio [HR] = 0.96; 95% confidence interval [CI] = 0.95 to 0.97), with similar patterns for individual cancers: colorectal (HR = 0.95; CI = 0.93 to 0.97); lung (HR = 0.95; CI = 0.94 to 0.97); breast (HR = 0.96; CI = 0.93 to 0.99); and prostate (HR = 0.88; CI = 0.85 to 0.91). Similarly, for cancer patients from these practices, there were lower odds of late-stage diagnosis for individual cancer types, except for colorectal cancer.
conclusionHigher practice use of referrals for suspected cancer is associated with lower mortality for the four most common types of cancer. A significant proportion of the observed mortality reduction is likely due to earlier stage at diagnosis, except for colorectal cancer. This adds to evidence supporting the lowering of referral thresholds and consequent increased use of urgent referral for suspected cancer.
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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.