Breast cancer recurrence: socioeconomic position and general practice involvement - a nationwide cohort study in...

General practitioners (GPs) play an increasingly central role in the detection and management of breast cancer recurrence (BCR). Socioeconomic position (SEP) has been associated with both risk of BCR and mortality and may influence cancer awareness and beliefs, healthcare-seeking behaviour, referral patterns, and access to and use of healthcare. Nevertheless, knowledge on how SEP is related to BCR detection in general practice remains limited.

To characterise patients with BCR and examine how SEP is associated with involvement of general practice in the pathway to recurrence diagnosis (index consultation), symptom presentation in general practice, and the GP's decision to initiate a diagnostic pathway.

In this nationwide retrospective cohort study, national register data on women diagnosed with BCR between 1 January 2022 and 31 May 2024 were combined with GP survey data from 324 Danish GPs. SEP was measured as educational level and cohabitation status. Associations with study outcomes were analysed by estimating prevalence ratios using Poisson regression models.

Among 392 women with BCR, 52.8% had an index consultation in general practice, 37.2% presented with symptoms in general practice, and 43.6% had the diagnostic pathway initiated by the GP. Across all analyses, no statistically significant associations were found between SEP and the investigated outcomes.

The findings suggest no substantial socioeconomic disparities in the likelihood of having an index consultation in general practice, presenting with symptoms in general practice, or having the diagnostic pathway initiated by the GP when presenting with symptoms.