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Increased diagnostic activity in general practice during the year preceding colorectal cancer diagnosis
Author(s) -
Hansen Pernille Libach,
Hjertholm Peter,
Vedsted Peter
Publication year - 2015
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.29418
Subject(s) - medicine , medical prescription , colorectal cancer , confidence interval , odds ratio , rate ratio , cancer , cohort , incidence (geometry) , diagnosis code , cancer registry , cohort study , population , hemorrhoids , surgery , environmental health , pharmacology , physics , optics
Accurate diagnostic activity in general practice before colorectal cancer (CRC) diagnosis is crucial for an early detection of CRC. This study aimed to investigate the rates of daytime consultations, hemoglobin (Hb) measurements and medicine prescriptions for hemorrhoids in general practice in the year preceding CRC diagnosis. Using Danish registries, we conducted a population‐based matched cohort study including CRC patients aged 40–80 years ( n = 19,209) and matched references ( n = 192,090). We calculated odds ratios (ORs) using a conditional logistical regression model and incidence rate ratios (IRRs) using a negative binomial regression model. The CRC patients had significantly more consultations from 9 months before diagnosis and significantly increased rates of Hb measurements from up to 17 months before diagnosis compared with references. Furthermore, up to 18 months before diagnosis, CRC patients had significantly higher rates of prescriptions for hemorrhoids; and 2 months before diagnosis, the IRR was 12.24 (95% confidence interval (CI): 10.29–14.55) for men. The positive predictive value (PPV) of CRC for having a first‐time prescription for hemorrhoids was highest among men aged 70–80 years [PPV = 3.2% (95% CI: 2.8–3.7)]. High prescription rates were predominantly seen among rectal cancer patients, whereas colon cancer patients had higher rates of consultations and Hb measurements. This study revealed a significant increase in healthcare seeking and diagnostic activity in general practice in the year prior to CRC diagnosis, which indicates the presence of a “diagnostic time window” and a potential for earlier diagnosis of CRC based on clinical signs and symptoms.