Clinical characteristics and risk of serious disease in patients referred to a diagnostic centre: A cohort study. (October 2017)

• Record Type: Journal Article
• Authors: Næser, Esben; Fredberg, Ulrich; Møller, Henrik; Vedsted, Peter
• Is Part Of: Cancer epidemiology. Volume 50: Part A(2017:Oct.)
• Page Start: 158
• Page End: 165
• Publication Date: 2017-10
• Subjects: DCR Danish Cancer Registry -- GP general practitioner -- NPR National Patient Registry; Early cancer diagnosis -- Neoplasm -- Urgent referral -- Denmark -- General practice; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2017.07.014
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: The risk of serious disease was 34% in patients referred to the diagnostic centre. The diagnoses consisted of both malignant (12%) and non-malignant diseases (22%). Patients presented with various symptoms and signs. A multidisciplinary diagnostic approach is needed at the diagnostic centre. Abstract: Background: Little is known about the clinical characteristics of patients referred to a diagnostic centre through the Danish urgent referral pathway for non-specific serious symptoms. We aimed at estimating the distribution of serious disease and the diagnostic value of clinical characteristics for the diagnosis of cancer and serious non-malignant disease in these patients. Method: A cohort study of 938 patients referred by their GP to the diagnostic centre at Silkeborg Regional Hospital. All patients were followed up for three months in national registries. The likelihood ratio (LR) of cancer or serious non-malignant disease were calculated in relation to clinical characteristics. Results: A total of 327 (34.9%) patients were diagnosed with new serious disease within three months: 118 patients (12.6%) with malignant disease and 209 patients (22.3%) with non-malignant disease. Most patients presented general symptoms. The highest LR of cancer was found for abdominal mass, high lactate dehydrogenase or abnormal findings in the diagnostic imaging. The highest LR of non-malignant disease was found for swollen joints or abnormal auscultation of lung or chest. Conclusions: Patients referred by their GP to the diagnostic centre have high risk of serious disease. A multidisciplinary diagnostic approach is needed to embrace the diagnostic spectrum.