Work

Patterns of diagnostic testing for oesophagogastric cancer-related symptoms in Australian primary care: a retrospective cohort study

Year: 2025

Type: article

Abstract: Background Oesophagogastric (OG) cancer-associated symptoms are common in primary care, but most research has focused on patients with a confirmed OG cancer diagnosis, rather than those presenting with symptoms for the first time. Aim To examine diagnostic testing patterns for upper gastrointestinal (GI) symptoms linked to OG cancer. Design and setting A retrospective cohort study was undertaken, which used a linked primary care database. It included de-identified patients aged >55 years who presented with symptoms suggestive of OG cancer between 2008 and 2022. Method The study analysed the proportion of patients who underwent pathology, imaging, referral, upper GI endoscopy, or a test of treatment. Differences across socioeconomic groups were also examined, along with the proportion of patients diagnosed with OG cancer. Results The study cohort consisted of 44 402 patients, of whom 126 (0.3%) were diagnosed with OG cancer within 12 months of presentation. Reflux was the most common symptom (57%), followed by nausea (11%). Patients aged ≥75 years were less likely to be investigated or referred than those aged 56–64 years (odds ratio [OR] 0.59, 95% confidence interval [CI] = 0.56 to 0.62, P<0.001). Those from less disadvantaged areas were 1.4 times more likely to be investigated than people from the most disadvantaged areas (OR 1.44, 95% CI = 1.36 to 1.53, P<0.001). Patients on test-of-treatment medications were less likely to receive further investigation (OR 0.66, 95% CI = 0.63 to 0.69, P<0.001). Multiple symptoms and visits increased the likelihood of investigation (OR 2.77, 95% CI = 2.55 to 3.00, P<0.001). Conclusion Significant variations in diagnostic testing could contribute to disparities in OG cancer outcomes.

Source: British Journal of General Practice

DOI: 10.3399/bjgp.2024.0621

Authors: Shaoke Lei, Brent Venning, Alison Pearce, Alex Lee, Jon Emery

Institutions: The University of Melbourne, Victorian Comprehensive Cancer Centre, The University of Sydney, Cancer Council NSW

Language: English

Topic: Gastrointestinal Bleeding Diagnosis and Treatment

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: hybrid

Funders: Cancer Research UK, Department of Health, State Government of Victoria, Medical Research Council, National Health and Medical Research Council