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Cancer-related gut feelings among Dutch general practitioners.

Donker, G., Dorsman, S. Cancer-related gut feelings among Dutch general practitioners.: , 2013. 46 p. Abstract. In: Abstractbook 6th Annual Meeting of the Cancer and Primary Care Research International (Ca-PRI) network. 15th-16th april 2013, Cambridge.
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Background: General practitioners (GPs) use their gut feeling as a tool for suspecting cancer
although quantitative research on the issue hardly exists. Objectives: To study the triggers of gut feelings, the interventions following these feelings and a potential association between these triggers and a correctly predicted diagnosis of cancer. Methods: Data were collected through the Dutch Sentinel General Practice Network consisting of 42 practices by recording a questionnaire for each patient causing a gut feeling related to cancer from January 2010 until June 2012. In a follow-up questionnaire after 3 months GPs recorded the patients’ final diagnosis. Associations between the triggers of gut feelings and the anticipated cancer diagnosis were analyzed through multivariate logistic regression analysis. Results: Within the Dutch Sentinel GP Network, there were on average 78 per 10,000 newly identified cases of cancer per year in the study period. GPs recorded gut feelings in 20 per 10,000 registered patients per year (N=264). Inexplicable weight loss was mentioned as a trigger most frequently (19.3%). Patient and/or family history (OR: 2.66) was positively and inexplicable weight loss (OR: 0.35) negatively associated with a correctly predicted cancer diagnosis (p<0.05). Gut feelings lead to further diagnostic action in almost all cases: mostly referral to a specialist (62%) laboratory (33%) and X-ray examination (22%). Follow-up after 3 months showed that a cancer diagnosis was confirmed in 36% and the anticipated cancer diagnosis in 28% of the cases (N=236). A serious non-cancer diagnosis was confirmed in 4.5% of the total sample. Conclusion: Gut feelings almost always incited further diagnostic action and a cancer diagnosis was confirmed in more than one third of the cases. While family and/or patient history appears a relevant cause of GPs’ gut feeling predicting cancer, other associations between triggers of gut feelings and a confirmed diagnosis of cancer were absent.