Table 4 Distribution of referrals, cancer probability, crude PRR and adjusted PRR according to referral characteristics, primary care interval, GP’s suspicion of cancer and GP’s gut feeling
Referrals (%) | Probability of cancer (%) | Crude PRR for cancer (95% CI) | Adjusted PRR for cancer (95% CI)a | |||
|---|---|---|---|---|---|---|
All | 1278 (100%) | 207 (16.2%) | ||||
Hospital | Silkeborg | 705 (55.2%) | 101 (14.3%) | 1 (ref) | 1 (ref) | |
Aarhus | 573 (44.8%) | 106 (18.5%) | 1.29 (1.01–1.66) | 1.22 (0.95–1.56) | ||
Referral to further examination at diagnostic centre | Silkeborg | Yes | 415 (59.0%) | 49 (11.8%) | 1 (ref) | 1 (ref) |
No | 289 (41.0%) | 52 (18.0%) | 1.64 (1.05-2.50) | 1.62 (1.05-2.50) | ||
Aarhus | Yes | 75 (18.8%) | 12 (16.0%) | 1 (ref) | 1 (ref) | |
No | 325 (81.2%) | 63 (19.4%) | 1.26 (0.64-2.48) | 1.22 (0.62-2.41) | ||
Sex | Female | 671 (52.5%) | 95 (14.2%) | 1 (ref) | 1 (ref) | |
Male | 607 (47.5%) | 112 (18.5%) | 1.30 (1.02-1.67) | 1.32 (1.03-1.70) | ||
Age group | 18-39 years | 70 (5.5%) | 3 (4.3%) | 0.96 (0.26-3.51) | 0.95 (0.26-3.49) | |
40-54 years | 179 (14.0%) | 8 (4.5%) | 1 (ref) | 1 (ref) | ||
55-69 years | 441 (34.5%) | 80 (18.1%) | 4.06 (2.00-8.22) | 4.01 (1.98-8.12) | ||
70-79 years | 345 (27.0%) | 73 (21.2%) | 4.73 (2.33-9.60) | 4.76 (2.35-9.64) | ||
≥ 80 years | 243 (19.0%) | 43 (17.7%) | 3.96 (1.91-8.21) | 3.31 (1.90-8.15) | ||
Patients with previous cancer | No | 1134 (88.7%) | 186 (16.4%) | 1 (ref) | 1 (ref) | |
Yes | 144 (11.3%) | 21 (14.6%) | 0.89 (0.59-1.35) | 0.80 (0.52-2.20) | ||
Symptoms at referral | 0 | 23 (1.8%) | 6 (26.1%) | 1.96 (0.92-4.15) | 1.88 (0.89-3.95) | |
(n=1254) | 1 | 240 (19.0%) | 32 (13.3%) | 1 (ref) | 1 (ref) | |
2 | 276 (21.9%) | 31 (11.2%) | 0.84 (0.53-1.34) | 0.82 (0.52-1.29) | ||
3 | 278 (22.0%) | 47 (16.9%) | 1.27 (0.84-1.92) | 1.26 (0.84-1.91) | ||
4 | 206 (16.3%) | 38 (18.5%) | 1.38 (0.90-2.13) | 1.38 (0.90-2.12) | ||
5 | 118 (9.3%) | 27 (22.9%) | 1.72 (1.08-2.72) | 1.68 (1.06-2.65) | ||
≥6 | 122 (9.7%) | 28 (18.9%) | 1.41 (0.87-2.30) | 1.35 (0.83-2.18) | ||
Clinical findings at referral | 0 | 147 (3.3%) | 9 (6.1%) | 1 (ref) | 1 (ref) | |
1 | 580 (52.4%) | 80 (13.8%) | 2.25 (1.16-4.82) | 1.98 (1.02-3.84) | ||
(n=1100) | 2 | 297 (26.9%) | 67 (22.6%) | 3.68 (1.89-7.18) | 3.04 (1.56-5.92) | |
≥3 | 82 (7.4%) | 19 (23.2%) | 3.78 (1.80-7.98) | 3.25 (1.55-6.81) | ||
Diagnostic test results at referral | 0 | 187 (17.1%) | 13 (7.0%) | 1 (ref) | 1 (ref) | |
1 | 565 (51.7%) | 98 (17.4%) | 2.50 (1.34-4.34) | 2.16 (1.24-3.77) | ||
(n=1086) | 2 | 267 (24.4%) | 41 (16.4%) | 2.21 (1.22-4.01) | 1.95 (1.07-3.53) | |
≥3 | 75 (6.9%) | 13 (17.3%) | 2.49 (1.21-5.13) | 2.28 (1.11-4.66) | ||
Number of chronic diseases at referral | 0 | 295 (24.5%) | 50 (17.0%) | 1 (ref) | 1 (ref) | |
1 | 403 (33.5%) | 62 (15.4%) | 0.91 (0.65-1-28) | 0.73 (0.52-1.02) | ||
(n=1199) | 2 | 286 (23.5%) | 48 (16.8%) | 0.99 (0.69-1.42) | 0.71 (0.49-1.02) | |
≥3 | 220 (18.2%) | 34 (15.5%) | 0.91 (0.61-1.36) | 0.63 (0.42-0.95) | ||
Primary care intervalb | <1 month | 723 (56.6%) | 117 (16.2%) | 1 (ref) | 1 (ref) | |
(n=1131) | 1-2 months | 156 (12.2%) | 20 (12.8%) | 0.79 (0.51-1.23) | 0.81 (0.52-1.26) | |
2-3 months | 79 (6.2%) | 16 (20.3%) | 1.25 (0.78-2.00) | 1.31 (0.82-2.07) | ||
3-4 months | 52 (4.1%) | 12 (23.1%) | 1.43 (0.85-2.41) | 1.42 (0.85-2.39) | ||
4-5 months | 29 (2.3%) | 6 (20.7%) | 1.28 (0.62-2.66) | 1.36 (0.67-2.76) | ||
5-6 months | 17 (1.3%) | 3 (17.7%) | 1.10 (0.39-3.09) | 1.26 (0.47-3.39) | ||
>6 months | 222 (17.3%) | 33 (14.9%) | 0.92 (0.64-1.31) | 0.90 (0.64-1.29) | ||
GP’s estimation of patient’s risk of cancer at referral | 0-20% | 448 (36.8%) | 36 (8.0%) | 1 (ref) | 1 (ref) | |
21-40% | 195 (16.0%) | 24 (12.3%) | 1.53 (0.94-2.50) | 1.43 (0.88-2.33) | ||
41-60% | 314 (25.8%) | 47 (15.0%) | 1.86 (1.24-2.81) | 1.69 (1.12-2.56) | ||
(n=1208) | 61-80% | 155 (12.6%) | 41 (26.5%) | 3.29 (2.19-4.95) | 2.96 (1.96-4.48) | |
81-100% | 104 (8.6%) | 52 (50.0%) | 6.22 (4.31-8.99) | 5.30 (3.62-7.76) | ||
Did gut feeling influence the decision of referral? | No | 287 (24.6%) | 46 (16.0%) | 1 (ref) | 1 (ref) | |
A little | 224 (19.2%) | 25 (11.2%) | 0.66 (0.39-1.11) | 0.65 (0.38-1.10) | ||
Some | 425 (36.4%) | 63 (14.8%) | 0.91 (0.60-1.38) | 0.86 (0.56-1.31) | ||
(n=1168) | Much | 182 (15.6%) | 43 (23.6%) | 1.62 (1.02-2.58) | 1.55 (0.97-2.48) | |
Very much | 50 (4.3%) | 17 (34.0%) | 2.70 (1.39-5.25) | 2.57 (1.31-5.05) | ||