Colon cancer diagnosed in patients with non-specific symptoms – comparisons between diagnostic paradigms

Damhus, Christina Sadolin; Siersma, Volkert; Birkmose, Anna Rubach; Støvring, Henrik; Dalton, Susanne Oksbjerg; Brodersen, John

doi:10.1080/0284186x.2023.2185910

Acta Oncologica

2023

DOI: 10.1080/0284186x.2023.2185910

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Colon cancer diagnosed in patients with non-specific symptoms – comparisons between diagnostic paradigms

Christina Sadolin Damhus

Volkert Siersma

Anna Rubach Birkmose

et al.

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2024

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Cited by 2 publications

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Diagnostic flow for all patients referred with non-specific symptoms of cancer to a diagnostic centre in Denmark: A descriptive study

Damhus,

Brodersen,

Nielsen

2024

European Journal of General Practice

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Background Since 2012, Cancer Patient Pathways for Non-specific Symptoms and Signs of Cancer (NSSC-CPP) have been implemented in Scandinavia and UK. Objectives This study aimed to describe the diagnostic flow for all patients referred from 1 January to 30 June 2020 to the NSSC-CPP in the Diagnostic Centre in Farsø (DC-F), Denmark. Methods During the study period, we prospectively recorded information on the diagnostic flow, including: pathway trajectory, symptoms and findings leading to referral, diagnostic procedures and diagnoses at the end of DC Farsø work-up and within 6-months for all patients referred to the NSSC-CPP in DC Farsø using electronic patient files and the Danish National Patient Registry (DNPR). Results Of the 314 referrals to DC Farsø, 227 had diagnostic work-up in DC Farsø, the remaining were redirected to other CPPs ( n = 11), outpatient clinics ( n = 45) or redirected to general practice ( n = 25). Of total referrals, 25 (8%) received a malignant diagnosis, 20 (6%) a non-malignant but clinically relevant diagnosis with initiation of treatment, 16 (5%) a non-malignant diagnosis but no treatment needed and in 253 (81%) referrals no severe new condition was diagnosed. Two (1%) additional malignancies were diagnosed within a 6-month follow-up period. Conclusion By tracking all patients referred to the NSSC-CPP in DC Farsø, including those redirected, this is the first study to describe the diagnostic flow for all patients referred to a diagnostic centre in Denmark. This knowledge is important for further organisation and planning of the NSSC-CPP.

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Diagnostic flow for all patients referred with non-specific symptoms of cancer to a diagnostic centre in Denmark: A descriptive study

Damhus,

Brodersen,

Nielsen

2024

European Journal of General Practice

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Rethinking the logic of early diagnosis in cancer

Damhus,

Risør,

Brodersen

et al. 2024

Health (London)

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To reduce morbidity and mortality of cancer, more countries have implemented strategies to detect cancer, based on the logic of ‘the sooner the better’. Time is thereby an essential component in how cancer research, policies, and prevention are practiced today. Where the logic of early diagnosis benefits some, the logic also produces harms. In this article, we use a cross-disciplinary case-study design to discuss how different notions of time and linearity are essential in today’s research ontology of cancer, describe the individual and societal consequences of such ontology, and invite a rethinking of time in cancer. Drawing on theoretical concepts of time together with cancer epidemiological, historical and ethnographical data, we analyse how the logic of early diagnosis has been established as a stable concept. Although evidence supporting the logic points in different directions, the message ‘the sooner the better’ is currently not being challenged by research, policy or society. This at least partly, can be explained by a linear perception of time and societal traces of neoliberalism and acceleration in our society together with cancer still being a somewhat enigmatic disease that requires acute action. To support a sustainable healthcare sector, we argue there is a need to nuance the logic of early diagnosis. Continuing the linear perception of symptoms and cancer, risks doing more harm than good by making more people patients unnecessarily and by spending health resources on those with the least need.

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Colon cancer diagnosed in patients with non-specific symptoms – comparisons between diagnostic paradigms

Cited by 2 publications

References 28 publications

Diagnostic flow for all patients referred with non-specific symptoms of cancer to a diagnostic centre in Denmark: A descriptive study

Diagnostic flow for all patients referred with non-specific symptoms of cancer to a diagnostic centre in Denmark: A descriptive study

Rethinking the logic of early diagnosis in cancer

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