Use of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.

<h4>Objective</h4>Childhood cancer is rare and symptoms tend to be unspecific and vague. Using the utilization of health care services as a proxy for symptoms, the present study seeks to determine when early symptoms of childhood cancer are seen in general practice.<h4>Methods</...

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Autores principales:	Jette Møller Ahrensberg, Morten Fenger-Grøn, Peter Vedsted
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/efc3ec4fa1584120acdb301a1f25ef1c
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spelling	oai:doaj.org-article:efc3ec4fa1584120acdb301a1f25ef1c2021-11-18T07:53:46ZUse of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.1932-620310.1371/journal.pone.0059098https://doaj.org/article/efc3ec4fa1584120acdb301a1f25ef1c2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23554980/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Childhood cancer is rare and symptoms tend to be unspecific and vague. Using the utilization of health care services as a proxy for symptoms, the present study seeks to determine when early symptoms of childhood cancer are seen in general practice.<h4>Methods</h4>A population-based matched comparative study was conducted using nationwide registry data. As cases, all children in Denmark below 16 years of age (N = 1,278) diagnosed with cancer (Jan 2002-Dec 2008) were included. As controls, 10 children per case matched on gender and date of birth (N = 12,780) were randomly selected. The utilization of primary health care services (daytime contacts, out-of-hours contacts and diagnostic procedures) during the year preceding diagnosis/index date was measured for cases and controls.<h4>Results</h4>During the six months before diagnosis, children with cancer used primary care more than the control cohort. This excess use grew consistently and steadily towards the time of diagnosis with an IRR = 3.19 (95%CI: 2.99-3.39) (p<0.0001) during the last three months before diagnosis. Children with Central Nervous System (CNS) tumours had more contacts than other children during the entire study period. The use of practice-based diagnostic tests and the number of out-of-hours contacts began to increase four to five months before cancer diagnosis.<h4>Conclusions</h4>The study shows that excess health care use, a proxy for symptoms of childhood cancer, occurs months before the diagnosis is established. Children with lymphoma, bone tumour or other solid tumours had higher consultation rates than the controls in the last five months before diagnosis, whereas children with CNS tumour had higher consultation rates in all twelve months before diagnosis. More knowledge about early symptoms and the diagnostic pathway for childhood cancer would be clinically relevant.Jette Møller AhrensbergMorten Fenger-GrønPeter VedstedPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e59098 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jette Møller Ahrensberg Morten Fenger-Grøn Peter Vedsted Use of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.
description	<h4>Objective</h4>Childhood cancer is rare and symptoms tend to be unspecific and vague. Using the utilization of health care services as a proxy for symptoms, the present study seeks to determine when early symptoms of childhood cancer are seen in general practice.<h4>Methods</h4>A population-based matched comparative study was conducted using nationwide registry data. As cases, all children in Denmark below 16 years of age (N = 1,278) diagnosed with cancer (Jan 2002-Dec 2008) were included. As controls, 10 children per case matched on gender and date of birth (N = 12,780) were randomly selected. The utilization of primary health care services (daytime contacts, out-of-hours contacts and diagnostic procedures) during the year preceding diagnosis/index date was measured for cases and controls.<h4>Results</h4>During the six months before diagnosis, children with cancer used primary care more than the control cohort. This excess use grew consistently and steadily towards the time of diagnosis with an IRR = 3.19 (95%CI: 2.99-3.39) (p<0.0001) during the last three months before diagnosis. Children with Central Nervous System (CNS) tumours had more contacts than other children during the entire study period. The use of practice-based diagnostic tests and the number of out-of-hours contacts began to increase four to five months before cancer diagnosis.<h4>Conclusions</h4>The study shows that excess health care use, a proxy for symptoms of childhood cancer, occurs months before the diagnosis is established. Children with lymphoma, bone tumour or other solid tumours had higher consultation rates than the controls in the last five months before diagnosis, whereas children with CNS tumour had higher consultation rates in all twelve months before diagnosis. More knowledge about early symptoms and the diagnostic pathway for childhood cancer would be clinically relevant.
format	article
author	Jette Møller Ahrensberg Morten Fenger-Grøn Peter Vedsted
author_facet	Jette Møller Ahrensberg Morten Fenger-Grøn Peter Vedsted
author_sort	Jette Møller Ahrensberg
title	Use of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.
title_short	Use of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.
title_full	Use of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.
title_fullStr	Use of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.
title_full_unstemmed	Use of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.
title_sort	use of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/efc3ec4fa1584120acdb301a1f25ef1c
work_keys_str_mv	AT jettemøllerahrensberg useofprimarycareduringtheyearbeforechildhoodcancerdiagnosisanationwidepopulationbasedmatchedcomparativestudy AT mortenfengergrøn useofprimarycareduringtheyearbeforechildhoodcancerdiagnosisanationwidepopulationbasedmatchedcomparativestudy AT petervedsted useofprimarycareduringtheyearbeforechildhoodcancerdiagnosisanationwidepopulationbasedmatchedcomparativestudy
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Use of primary care during the year before childhood cancer diagnosis: a nationwide population-based matched comparative study.

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