Are GPs under-investigating older patients presenting with symptoms of ovarian cancer? Observational study using General Practice Research Database

Tate, A.R., Nicholson, A. and Cassell, J. A. (2010) Are GPs under-investigating older patients presenting with symptoms of ovarian cancer? Observational study using General Practice Research Database. British Journal of Cancer, 102 (6). pp. 947-951. ISSN 0007-0920

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Abstract

Background: Recent studies suggest that older patients in the United Kingdom are not benefiting as much from improvements in cancer treatments as their younger counterparts. We investigate whether this might be partly due to differential referral rates using ovarian cancer as an example. Methods: From the General Practice Research Database (GPRD), we identified all women aged 40–80 years on 1 June 2002 with a Read code for ovarian cancer between 1 June 2002 and 31 May 2007. Using these records, we compared the GPRD incidence of ovarian cancer with rates compiled from the UK cancer registries and investigated the relationship between age and coded investigations for suspected ovarian cancer. Results: The GPRD rates peaked earlier, at 70–74, and were lower than registry rates for nearly all ages particularly for patients over 59. The proportion investigated or referred by the GP decreased significantly with age and delays between first coded symptom and investigation showed a U-shaped distribution by age. Conclusions: GPs appear to be less likely to recognise and to refer patients presenting with ovarian cancer as they get older. If our findings extend to other cancers, lack of or delays in referral to secondary care may partly explain poor UK cancer mortality rates of older people.

Item Type: Article
Keywords: primary care delay; secondary care referral; patient age
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology Including cancer and carcinogens
R Medicine > RD Surgery > RD0651 Neoplasms. Tumors. Oncology
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Depositing User: Caroline Brooks
Date Deposited: 03 Jun 2010
Last Modified: 09 Mar 2017 06:02
URI: http://sro.sussex.ac.uk/id/eprint/2343
Google Scholar:8 Citations

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