Cancer patients' experiences with urgent referrals to cancer patient pathways

Eur J Cancer Care (Engl). 2019 Jan;28(1):e12927. doi: 10.1111/ecc.12927. Epub 2018 Oct 10.

Abstract

Objective: We aimed to explore whether cancer patients urgently referred to a cancer patient pathway (CPP) (CPP referred) by a general practitioner report experiences of pre-diagnosis cancer care differently than patients not referred to a CPP (non-CPP referred).

Methods: Data were collected from cross-sectional questionnaire surveys among cancer patients and their GPs and linked to National registries. Poisson regression was used to generate adjusted prevalence ratios (PR) to compare reported experiences.

Results: The study included 2,256 individuals. CPP referred patients reported more positive overall experiences of the pre-diagnosis phase (p < 0.001). Overall, CPP referred patients were 21% more likely than non-CPP referred patients to report a positive experience after adjustment for case-mix, comorbidity, disposable household income and educational level (PR = 1.21 [95% CI: 1.11-1.30]). The difference decreased to 14% when adjusted for Quality Deviations (PR = 1.14 [95% CI: 1.06-1.23]) and to 11% when adjusted for diagnostic interval (PR = 1.11 [95% CI: 1.02-1.20]).

Conclusion: Our findings suggest that CPP referred cancer patients have better experiences of pre-diagnosis cancer care compared to non-CPP referred patients. A substantial part of the difference could be attributed to shorter diagnostic intervals and/or the absence of quality deviations among CPP patients, which reveals the potential for generally improving cancer patients' experiences by seamless and optimised diagnostic pathways.

Keywords: cancer; cancer patient pathways; general practice; neoplasm; patient experiences.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Critical Pathways*
  • Cross-Sectional Studies
  • Female
  • General Practitioners
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / diagnosis*
  • Neoplasms / therapy
  • Referral and Consultation*
  • Registries*
  • Surveys and Questionnaires
  • Young Adult