The British journal of general practice : the journal of the Royal College of General Practitioners · 2012
Presenting symptoms of children with cancer: a primary-care population-based study.
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Ahrensberg Jette Møller, Hansen Rikke Pilegaard, Olesen Frede, Schrøder Henrik, Vedsted Peter
Аннотация
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.
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.