BACKGROUND: Knowledge of how children with cancer present in general practice is sparse. Timely referral from general practice is important to ensure early diagnosis. AIM: To investigate the presenting symptoms and GPs' interpretations of symptoms of children with cancer. DESIGN AND SETTING: A Danish nationwide population-based study including children (<15 years) with an incident cancer diagnosis (January 2007 to December 2010). METHOD: A questionnaire on symptoms and their interpretation was mailed to GPs (n=363). Symptoms were classified according to the International Classification of Primary Care (ICPC)-2 classification. RESULTS: GPs' response rate was 87% (315/363) and GPs were involved in the diagnostic process of 253 (80.3%) children. Symptoms were few (2.4 per child) and most fell into the category 'general and unspecified' (71.9%), apart from patients with tumours of the central nervous system (CNS), whose symptoms fell mostly in the category 'neurological' (for example, headache). Symptoms like pain, swelling/lump, or fatigue were reported in 25% of the patients and they were the most commonly reported symptoms. GPs interpreted children's symptoms as alarm symptoms in 20.2%, as serious (that is, not alarm) symptoms in 52.9%, and as vague symptoms in 26.9%. GPs' interpretation varied significantly by diagnosis (P<0.001). CONCLUSION: Children with cancer presented with few symptoms in general practice, of which most were 'general and unspecified' symptoms. Only 20% presented alarm symptoms, while 27% presented vague and non-specific symptoms. This low level of alarm symptoms may influence the time from symptom presentation in general practice to final diagnosis.
BACKGROUND: Knowledge of how children with cancer present in general practice is sparse. Timely referral from general practice is important to ensure early diagnosis. AIM: To investigate the presenting symptoms and GPs' interpretations of symptoms of children with cancer. DESIGN AND SETTING: A Danish nationwide population-based study including children (<15 years) with an incident cancer diagnosis (January 2007 to December 2010). METHOD: A questionnaire on symptoms and their interpretation was mailed to GPs (n=363). Symptoms were classified according to the International Classification of Primary Care (ICPC)-2 classification. RESULTS: GPs' response rate was 87% (315/363) and GPs were involved in the diagnostic process of 253 (80.3%) children. Symptoms were few (2.4 per child) and most fell into the category 'general and unspecified' (71.9%), apart from patients with tumours of the central nervous system (CNS), whose symptoms fell mostly in the category 'neurological' (for example, headache). Symptoms like pain, swelling/lump, or fatigue were reported in 25% of the patients and they were the most commonly reported symptoms. GPs interpreted children's symptoms as alarm symptoms in 20.2%, as serious (that is, not alarm) symptoms in 52.9%, and as vague symptoms in 26.9%. GPs' interpretation varied significantly by diagnosis (P<0.001). CONCLUSION:Children with cancer presented with few symptoms in general practice, of which most were 'general and unspecified' symptoms. Only 20% presented alarm symptoms, while 27% presented vague and non-specific symptoms. This low level of alarm symptoms may influence the time from symptom presentation in general practice to final diagnosis.
Authors: D Weller; P Vedsted; G Rubin; F M Walter; J Emery; S Scott; C Campbell; R S Andersen; W Hamilton; F Olesen; P Rose; S Nafees; E van Rijswijk; S Hiom; C Muth; M Beyer; R D Neal Journal: Br J Cancer Date: 2012-03-13 Impact factor: 7.640
Authors: Rachel M Dommett; Theresa Redaniel; Michael C G Stevens; Richard M Martin; William Hamilton Journal: Br J Gen Pract Date: 2013-01 Impact factor: 5.386
Authors: Minjoung M Koo; Georgios Lyratzopoulos; Annie Herbert; Gary A Abel; Rachel M Taylor; Julie A Barber; Faith Gibson; Jeremy Whelan; Lorna A Fern Journal: JAMA Netw Open Date: 2020-09-01