Consultation frequency in general practice before cancer diagnosis in relation to the patient's usual consultation pattern: A population-based study

BACKGROUND: Cancer patients who usually consult the general practitioner (GP) rarely are generally diagnosed with more advanced stages of cancer. This subgroup of cancer patients may thus postpone relevant healthcare seeking.

AIM: We aimed to investigate the rates of daytime face-to-face consultations in general practice before a cancer diagnosis in patients with different categories of 'usual' consultation frequency.

MATERIAL AND METHODS: We conducted a population-based comparative study using register data on all 123,934 first-time cancer patients aged 50-90 years who were diagnosed in 2009-2013 in Denmark. Usual consultation rates were based on number of consultations from 19 to 36 months before cancer diagnosis. We predicted the marginal monthly consultation rates for up to 18 months before diagnosis. These were based on the estimated (mean) rates of consultations with corresponding 95% confidence intervals (CIs), which were calculated by negative binomial regression analysis with robust variance estimation.

RESULTS: Patients with cancer began to increase their consultation frequency four to six months before their cancer diagnosis. The average monthly consultation rates varied slightly across usual consultation groups; rates were lowest among male 'frequent' consulters (0.28 (95% CI: 0.27;0.29)) and highest among female 'frequent' consulters (0.35 (95% CI: 0.34;0.37)). The additional number of consultations was 1-2 for all combinations of usual consultation frequency, sex, and cancer type (except for female breast cancer and 'average' consulters with lung or prostate cancer).

CONCLUSION: Patients with cancer begin to increase their consultation frequency in general practice before a cancer diagnosis independently of their usual consultation frequency.