Esben Næser1, Henrik Møller2, Ulrich Fredberg3, Peter Vedsted4. 1. Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark; Research Centre for Cancer Diagnosis in Primary Care, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Falkevej 1-3, 8600 Silkeborg, Denmark. Electronic address: esben.naeser@rm.dk. 2. Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark; Research Centre for Cancer Diagnosis in Primary Care, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; Cancer Epidemiology and Population Health, King's College London, Great Maze Pond, London SE1 9RT, United Kingdom. 3. Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Falkevej 1-3, 8600 Silkeborg, Denmark. 4. Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark; Research Centre for Cancer Diagnosis in Primary Care, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Falkevej 1-3, 8600 Silkeborg, Denmark.
Abstract
BACKGROUND: 'Diagnostic Centres' has been established to provide a diagnostic pathway for patients with non-specific, serious symptoms that could be cancer. As little is known about the prognosis, we aimed to 1) analyse mortality of patients examined at the diagnostic centre, stratified on diagnostic outcome (cancer, serious-non-malignant disease, or other/no diagnosis), and 2) compare mortality for cancer patients examined at the diagnostic centre with cancer patients diagnosed through other routes. METHOD: Retrospective cohort study including 938 patients examined at the Diagnostic Centre, Silkeborg Regional Hospital, Denmark, during 2012-2014. Cancer patients examined at the diagnostic centre were matched (1:10) to a reference group of cancer patients diagnosed through other routes. Information on diagnosis, death, comorbidity and socioeconomic factors was obtained by linkage to national Danish registers. Mortality was assessed by Kaplan Meier mortality survival analysis and hazard ratios of death were estimated using Cox proportional regression analysis while adjusting for confounders. RESULTS: The 1-year cumulative mortality was 28% in cancer patients examined at the diagnostic centre. The hazard ratio of death was seven times increased in cancer patients compared to patients with other/no diagnosis. The hazard ratio of death was 0.91 (95% CI: 0.68; 1.22) in cancer patients examined at the diagnostic centre compared to cancer patients diagnosed through other routes. DISCUSSION: The mortality among cancer patients examined at the diagnostic centre was comparable to cancer patients diagnosed through other routes. The results indicate that cancer patients with non-specific serious symptoms do not have a worse prognosis than other cancer patients.
BACKGROUND: 'Diagnostic Centres' has been established to provide a diagnostic pathway for patients with non-specific, serious symptoms that could be cancer. As little is known about the prognosis, we aimed to 1) analyse mortality of patients examined at the diagnostic centre, stratified on diagnostic outcome (cancer, serious-non-malignant disease, or other/no diagnosis), and 2) compare mortality for cancerpatients examined at the diagnostic centre with cancerpatients diagnosed through other routes. METHOD: Retrospective cohort study including 938 patients examined at the Diagnostic Centre, Silkeborg Regional Hospital, Denmark, during 2012-2014. Cancerpatients examined at the diagnostic centre were matched (1:10) to a reference group of cancerpatients diagnosed through other routes. Information on diagnosis, death, comorbidity and socioeconomic factors was obtained by linkage to national Danish registers. Mortality was assessed by Kaplan Meier mortality survival analysis and hazard ratios of death were estimated using Cox proportional regression analysis while adjusting for confounders. RESULTS: The 1-year cumulative mortality was 28% in cancerpatients examined at the diagnostic centre. The hazard ratio of death was seven times increased in cancerpatients compared to patients with other/no diagnosis. The hazard ratio of death was 0.91 (95% CI: 0.68; 1.22) in cancerpatients examined at the diagnostic centre compared to cancerpatients diagnosed through other routes. DISCUSSION: The mortality among cancerpatients examined at the diagnostic centre was comparable to cancerpatients diagnosed through other routes. The results indicate that cancerpatients with non-specific serious symptoms do not have a worse prognosis than other cancerpatients.
Authors: Hans Thulesius; Ulrika Sandén; Davorina Petek; Robert Hoffman; Tuomas Koskela; Bernardino Oliva-Fanlo; Ana Luísa Neves; Senada Hajdarevic; Lars Harrysson; Berit Skjodeborg Toftegaard; Peter Vedsted; Michael Harris Journal: Scand J Prim Health Care Date: 2021-12-10 Impact factor: 2.581
Authors: Christina Sadolin Damhus; Volkert Siersma; Susanne Oksbjerg Dalton; John Brodersen Journal: Scand J Prim Health Care Date: 2021-02-25 Impact factor: 2.581
Authors: Susanne Oksbjerg Dalton; John Brodersen; Christina Sadolin Damhus; Volkert Siersma; Anna Rubach Birkmose Journal: BMC Health Serv Res Date: 2022-01-31 Impact factor: 2.655