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https://hdl.handle.net/2440/78683
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Type: | Journal article |
Title: | The varying role of the GP in the pathway between colonoscopy and surgery for colorectal cancer: a retrospective cohort study |
Author: | Goldsbury, D. Harris, M. Pascoe, S. Barton, M. Olver, I. Spigelman, A. Beilby, J. Veitch, C. Weller, D. O'Connell, D. |
Citation: | BMJ Open, 2013; 3(3):1-11 |
Publisher: | BMJ Group |
Issue Date: | 2013 |
ISSN: | 2044-6055 2044-6055 |
Statement of Responsibility: | David Goldsbury, Mark Harris, Shane Pascoe, Michael Barton, Ian Olver, Allan Spigelman, Justin Beilby, Craig Veitch, David Weller, Dianne L O'Connell |
Abstract: | Objectives: To describe general practitioner (GP) involvement in the treatment referral pathway for colorectal cancer (CRC) patients. Design: A retrospective cohort analysis of linked data. Setting: A population-based sample of CRC patients diagnosed from August 2004 to December 2007 in New South Wales, Australia, using the 45 and Up Study, cancer registry diagnosis records, inpatient hospital records and Medicare claims records. Participants: 407 CRC patients who had a colonoscopy followed by surgery. Primary outcome measures: Patterns of GP consultations between colonoscopy and surgery (ie, between diagnosis and treatment). We investigated whether consulting a GP presurgery was associated with time to surgery, postsurgical GP consultations or rectal cancer cases having surgery in a centre with radiotherapy facilities. Results: Of the 407 patients, 43% (n=175) had at least one GP consultation between colonoscopy and surgery. The median time from colonoscopy to surgery was 27 days for those with an intervening GP consultation and 15 days for those without the consultation. 55% (n=223) had a GP consultation up to 30 days postsurgery; it was more common in cases of patients who consulted a GP presurgery than for those who did not (65% and 47%, respectively, adjusted OR 2.71, 95% CI 1.50 to 4.89, p=0.001). Of the 142 rectal cancer cases, 23% (n=33) had their surgery in a centre with radiotherapy facilities, with no difference between those who did and did not consult a GP presurgery (21% and 25% respectively, adjusted OR 0.84, 95% CI 0.27 to 2.63, p=0.76). Conclusions: Consulting a GP between colonoscopy and surgery was associated with a longer interval between diagnosis and treatment, and with further GP consultations postsurgery, but for rectal cancer cases it was not associated with treatment in a centre with radiotherapy facilities. GPs might require a more defined and systematic approach to CRC management. |
Description: | Extent: 11p. |
Rights: | This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode |
DOI: | 10.1136/bmjopen-2012-002325 |
Published version: | http://dx.doi.org/10.1136/bmjopen-2012-002325 |
Appears in Collections: | Aurora harvest General Practice publications |
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hdl_78683.pdf | Published version | 381.24 kB | Adobe PDF | View/Open |
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