[Characteristics of diagnoses of malignant neoplasms in primary care]

To describe the diagnostic process of malignant neoplasms according to the level of care, initial symptoms and diagnostic procedures.Design. Retrospective descriptive study.

Health centre on the periphery of a big city.

Cases of malignant neoplasms recorded between 1990 and 2000 through the mortality register and specific recording in 2000.

We reviewed the records, obtaining age and gender, location, initial symptoms, date of first consultation and at what care level, diagnostic tests requested in primary care (PC) and the time elapsed until they became available, until the patients referral and until the definitive diagnosis. 274 cases were included, with information lacking for 12.

42.4% were women, with average age 67.6. The most frequent types of cancer were digestive, respiratory and masculine genital-urinary. 75.2% consulted initially in PC. The most common symptoms were pain and haemorrhage. Of those attended in PC, diagnostic tests were requested for 46.7%, the most common of these being basic analysis (53.2%) and simple x-ray (24.8%). Mean time before results were available was 15.4 days. 67.2% of all cases were referred. Mean time from consultation to referral was 7.3 days; and to definitive diagnosis, 68.0 days. However, for those initially attended in PC, the mean wait was 81.0 days; and at other levels, 30 days (P<.0001).

Most patients consult on their initial symptoms in PC. The time taken for the diagnostic process at this level is adequate, although the total length of the process is greater for those who first consulted in PC.