Risk of cancer and serious disease in Danish patients with urgent referral for serious non-specific symptoms and signs of cancer in Funen 2014–2021

Grønnemose, Rasmus Birkholm; Hansen, Per Syrak; Worsøe Laursen, Søren; Gerke, Oke; Kjellberg, Jakob; Lykkegaard, Jesper; Thye-Rønn, Clara; Høilund-Carlsen, Poul Flemming; Thye-Rønn, Peter

doi:10.1038/s41416-024-02620-y

Cited by 2 publications

(1 citation statement)

References 42 publications

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“…Amongst countries with a gatekeeper to specialist referrals (half of Europe, Australia, New Zealand and Canada) only the UK, Denmark, Sweden, Norway, Spain, New Zealand and Australia have guidelines for organ specific suspected cancer referrals ( 2 , 3 ) including suspected HNC ( 4 ). One Danish centre (Odense) reports a conversion rate from referral to cancer diagnosis as 29.2% (1 July 2012 to 1st September 2015) ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Nomenclature of the symptoms of head and neck cancer: a systematic scoping review

Bradley,

Lee,

Albutt

et al. 2024

Front. Oncol.

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IntroductionEvolution of a patient-reported symptom-based risk stratification system to redesign the suspected head and neck cancer (HNC) referral pathway (EVEREST-HN) will use a broad and open approach to the nomenclature and symptomatology. It aims to capture and utilise the patient reported symptoms in a modern way to identify patients’ clinical problems more effectively and risk stratify the patient.MethodThe review followed the PRISMA checklist for scoping reviews. A search strategy was carried out using Medline, Embase and Web of Science between January 1st 2012 and October 31st 2023. All titles, abstracts and full paper were screened for eligibility, papers were assessed for inclusion using predetermined criteria. Data was extracted pertaining to the aims, type of study, cancer type, numbers of patients included and symptoms, presenting complaints or signs and symptoms.ResultsThere were 9,331 publications identified in the searches, following title screening 350 abstracts were reviewed for inclusion and 120 were considered for eligibility for the review. 48 publications met the eligibility criteria and were included in the final review. Data from almost 11,000 HNC patients was included. Twenty-one of the publications were from the UK, most were retrospective examination of patient records. Data was extracted and charted according to the anatomical area of the head and neck where the symptoms are subjectively and objectively found, and presented according to lay terms for symptoms, clinical terms for symptoms and the language of objective clinical findings.DiscussionSymptoms of HNC are common presenting complaints, interpreting these along with clinical history, examination and risk factors will inform a clinician’s decision to refer as suspected cancer. UK Head and Neck specialists believe a different way of triaging the referrals is needed to assess the clinical risk of an undiagnosed HNC. EVEREST-HN aims to achieve this using the patient history of their symptoms. This review has highlighted issues in terms of what is considered a symptom, a presenting complaint and a clinical finding or sign.

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Section: Introductionmentioning

confidence: 99%

Nomenclature of the symptoms of head and neck cancer: a systematic scoping review

Bradley,

Lee,

Albutt

et al. 2024

Front. Oncol.

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Diagnostic Window Prior to a Haematological Cancer Diagnosis and the Association With Patient Pathways: A Nationwide Register‐Based Cohort Study on Healthcare Utilization in Denmark

Virgilsen,

Vedsted,

Jensen

et al. 2024

European J of Haematology

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ObjectivesThis study investigated healthcare utilisation in general practice and hospitals in the 2 years preceding a diagnosis of haematological cancer and the association with patient pathways.MethodsThe nationwide register‐based cohort study included 12 994 patients diagnosed with leukaemia, multiple myeloma and lymphoma in 2014–2018 and 10 matched references. Patient pathways were analysed in unplanned routes (acute admission up to 1 month's prior diagnosis) and elective routes (other routes, e.g., cancer patient pathways).ResultsFemale patients in unplanned diagnostic pathways had more contacts to general practice from 19 months before the diagnosis compared to their matched references; with IRR increasing from 1.14 (95% confidence interval (CI) 1.05–1.24) to 2.27 (95% CI 2.13–2.41) at 30–60 days before the diagnosis. Female patients had more point‐of‐care tests, hospital contacts and radiological investigations at 17, 24 and 17 months, respectively, before diagnosis compared to their references. Similar patterns were seen for male patients, although with a later onset of increase. No healthcare use variations were seen between patients diagnosed in unplanned versus elective pathways.ConclusionsIncreased healthcare utilisation was seen in general practice and hospitals up to 24 months preceding a diagnosis, which may indicate a diagnostic window for detecting haematological cancer earlier.

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Risk of cancer and serious disease in Danish patients with urgent referral for serious non-specific symptoms and signs of cancer in Funen 2014–2021

Cited by 2 publications

References 42 publications

Nomenclature of the symptoms of head and neck cancer: a systematic scoping review

Nomenclature of the symptoms of head and neck cancer: a systematic scoping review

Diagnostic Window Prior to a Haematological Cancer Diagnosis and the Association With Patient Pathways: A Nationwide Register‐Based Cohort Study on Healthcare Utilization in Denmark

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