Patient’s worry about cancer and the general practitioner’s suspicion of cancer or serious illness: A population‐based study in Denmark

Abstract

Although the literature is conflicting and the link between time and prognosis is complicated by, for example confounding by indication, recent studies suggest that the prognosis of cancer improves when the cancer is diagnosed in a timely manner (Neal et al., 2015;Rubin et al., 2015;Tørring et al., 2019). Thus, it is pivotal to continuously optimise cancer diagnostics and treatment. The majority of cancer patients initially consult their general practitioner (GP) with symptoms before diagnosis (Allgar and Neal, 2005;Hansen et al., 2011).Therefore, general practice plays an important role in the early diagnosis of cancer (Allgar and Neal, 2005;Rubin et al., 2015), for example through urgent referral of the patient to specialised diagnostic services.The GP's suspicion of cancer has been highlighted as an important element to ensure early diagnosis of cancer (Bradley et al., 2019). A study found that GPs were more likely to urgently refer patients when cancer was suspected at the first presentation of the patient, and that the cancer suspicion of the GP was a stronger predictor of shorter diagnostic intervals than the urgent referral per se (Jensen et al., 2014).

Psychiatric disorders and the cancer diagnostic process in general practice: a combined questionnaire and register study exploring the patients’ experiences in Denmark

“…This study showed that patients with psychiatric disorders may be more likely to worry about cancer when presenting symptoms to their GP. Given that this population was diagnosed with cancer, patient worry can be regarded as positive, as it has been associated with the GP suspecting cancer [ 48 ]. Yet, if worry is present regardless of a subsequent cancer in patients with psychiatric disorders [ 46 , 47 ], the GP must balance between patient worry due to psychiatric distress and worry due to potential cancer symptoms.…”

“…Yet, if worry is present regardless of a subsequent cancer in patients with psychiatric disorders [ 46 , 47 ], the GP must balance between patient worry due to psychiatric distress and worry due to potential cancer symptoms. This may represent a diagnostic challenge in this patient group as the GP’s suspicion of cancer can be based on, for example, the patient’s worry [ 48 ].…”