Cancer patients' experiences with urgent referrals to cancer patient pathways.

Abstract

We aimed to explore whether cancer patients urgently referred to a cancer patient pathway (CPP) (CPP referred) by a general practitioner report experiences of pre-diagnosis cancer care differently than patients not referred to a CPP (non-CPP referred). Data were collected from cross-sectional questionnaire surveys among cancer patients and their GPs and linked to National registries. Poisson regression was used to generate adjusted prevalence ratios (PR) to compare reported experiences. The study included 2,256 individuals. CPP referred patients reported more positive overall experiences of the pre-diagnosis phase (p<0.001). Overall, CPP referred patients were 21% more likely than non-CPP referred patients to report a positive experience after adjustment for case-mix, comorbidity, disposable household income and educational level (PR=1.21 [95% CI: 1.11-1.30]). The difference decreased to 14% when adjusted for Quality Deviations (PR=1.14 [95% CI: 1.06-1.23]) and to 11% when adjusted for diagnostic interval (PR=1.11 [95% CI: 1.02-1.20]). Our findings suggest that CPP referred cancer patients have better experiences of pre-diagnosis cancer care compared to non-CPP referred patients. A substantial part of the difference could be attributed to shorter diagnostic intervals and/or the absence of quality deviations among CPP patients, which reveals the potential for generally improving cancer patients' experiences by seamless and optimised diagnostic pathways.