Clinical activity in general practice before sarcoma diagnosis: an Australian cohort study

Area of Science:

• Oncology
• General Practice
• Health Services Research

Background:

• Delayed diagnosis of sarcoma is linked to poorer patient prognosis.
• Identifying opportunities to expedite sarcoma diagnosis in primary care is crucial.

Purpose of the Study:

• To investigate general practice (GP) clinical activity in the period preceding a sarcoma diagnosis.
• To identify potential diagnostic windows for earlier sarcoma detection.

Main Methods:

• A retrospective Australian cohort study utilized linked hospital registry (ACCORD) and primary care data (Patron, MedicineInsight).
• Compared healthcare utilization events (attendances, prescriptions, imaging requests) in soft tissue sarcoma (STS) and bone sarcoma (BS) patients in the year before diagnosis.
• Poisson regression analyzed monthly incidence rate ratios (IRR) for 24 months pre-diagnosis to identify increased healthcare use.

Main Results:

• Sarcoma patients had increased GP attendances from 3 months pre-diagnosis and imaging requests from 6 months pre-diagnosis.
• In the 6 months before diagnosis, 33-36% of patients had a GP imaging request, with 19-21% having multiple requests.
• GP imaging requests increased up to eight-fold (IRR 8.43) from 6 months pre-diagnosis.

Conclusions:

• Increased general practice clinical activity in sarcoma patients begins 6 months before diagnosis, highlighting a key diagnostic window.
• Interventions focusing on identifying at-risk patients and optimizing imaging and referral pathways can facilitate earlier diagnosis.
• Earlier diagnosis of sarcoma through improved primary care pathways can lead to better patient outcomes.