General practitioners’ clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries
Objective Relative one-year cancer survival rates in the Baltic states are lower than the European mean; in the Nordic countries they are higher than the mean. This study investigated the likelihood of General Practitioners (GPs) investigating or referring patients with a low but significant risk of...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-01-01
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| Series: | Scandinavian Journal of Primary Health Care |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/02813432.2025.2451653 |
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| author | Alexander Rosendahl Anet Vanaveski Liina Pilv-Toom Jānis Blumfelds Vija Siliņa Mette Brekke Tuomas Koskela Aurimas Rapalavičius Hans Thulesius Peter Vedsted Michael Harris |
| author_facet | Alexander Rosendahl Anet Vanaveski Liina Pilv-Toom Jānis Blumfelds Vija Siliņa Mette Brekke Tuomas Koskela Aurimas Rapalavičius Hans Thulesius Peter Vedsted Michael Harris |
| author_sort | Alexander Rosendahl |
| collection | DOAJ |
| description | Objective Relative one-year cancer survival rates in the Baltic states are lower than the European mean; in the Nordic countries they are higher than the mean. This study investigated the likelihood of General Practitioners (GPs) investigating or referring patients with a low but significant risk of cancer in these two regions, and how this was affected by GP demographics.Design A survey of GPs using clinical vignettes.Setting General Practice in Denmark, Estonia, Finland, Latvia, Lithuania, Norway, and Sweden.Subjects General Practitioners.Outcome measures A regional comparison of GPs’ stated immediate diagnostic actions (whether or not they would perform a key diagnostic test and/or refer to a specialist) for patients with a low but significant risk of cancer (between 1.2 and 3.6%).Results Of the 427 GPs that completed the questionnaire, those in the Baltic states, and GPs that were more experienced, were more likely to arrange a key diagnostic test and/or refer their patient to a specialist than those in Nordic Countries or who were less experienced (p < 0.001 for both measures). Neither GP sex nor practice location within a country showed a significant association with these measures.Conclusion While relative one-year cancer survival rates are lower in the Baltic states than in four Nordic countries, we found no evidence that this is due to their GPs’ reluctance to take immediate diagnostic action, as GPs in the Baltic states were more likely to investigate and/or refer at the first consultation. Research on patient and secondary care factors is needed to explain the survival differences. |
| format | Article |
| id | doaj-art-1fd06a122c6241a7be5c184589c86112 |
| institution | Kabale University |
| issn | 0281-3432 1502-7724 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Scandinavian Journal of Primary Health Care |
| spelling | doaj-art-1fd06a122c6241a7be5c184589c861122025-01-22T04:35:07ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242025-01-011810.1080/02813432.2025.2451653General practitioners’ clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countriesAlexander Rosendahl0Anet Vanaveski1Liina Pilv-Toom2Jānis Blumfelds3Vija Siliņa4Mette Brekke5Tuomas Koskela6Aurimas Rapalavičius7Hans Thulesius8Peter Vedsted9Michael Harris10Institute of Family Medicine and Public Health, University of Tartu, Tartu, EstoniaFamily Medicine Residency, University of Tartu, Tartu, EstoniaInstitute of Family Medicine and Public Health, University of Tartu, Tartu, EstoniaDepartment of Family Medicine, Riga Stradiņš University, Riga, LatviaDepartment of Family Medicine, Riga Stradiņš University, Riga, LatviaDepartment of General Practice, Institute of Health and Society, University of Oslo, Oslo, NorwayFaculty of Medicine and Health Technology, Tampere University, Tampere, FinlandDepartment of Family Medicine, Lithuanian University of Health Sciences, Kaunas, LithuaniaDepartment of Family Medicine, Riga Stradiņš University, Riga, LatviaResearch Unit for General Practice, Aarhus, DenmarkDepartment of Family Medicine, Riga Stradiņš University, Riga, LatviaObjective Relative one-year cancer survival rates in the Baltic states are lower than the European mean; in the Nordic countries they are higher than the mean. This study investigated the likelihood of General Practitioners (GPs) investigating or referring patients with a low but significant risk of cancer in these two regions, and how this was affected by GP demographics.Design A survey of GPs using clinical vignettes.Setting General Practice in Denmark, Estonia, Finland, Latvia, Lithuania, Norway, and Sweden.Subjects General Practitioners.Outcome measures A regional comparison of GPs’ stated immediate diagnostic actions (whether or not they would perform a key diagnostic test and/or refer to a specialist) for patients with a low but significant risk of cancer (between 1.2 and 3.6%).Results Of the 427 GPs that completed the questionnaire, those in the Baltic states, and GPs that were more experienced, were more likely to arrange a key diagnostic test and/or refer their patient to a specialist than those in Nordic Countries or who were less experienced (p < 0.001 for both measures). Neither GP sex nor practice location within a country showed a significant association with these measures.Conclusion While relative one-year cancer survival rates are lower in the Baltic states than in four Nordic countries, we found no evidence that this is due to their GPs’ reluctance to take immediate diagnostic action, as GPs in the Baltic states were more likely to investigate and/or refer at the first consultation. Research on patient and secondary care factors is needed to explain the survival differences.https://www.tandfonline.com/doi/10.1080/02813432.2025.2451653Cancergeneral practiceprimary health careearly diagnosisgeography |
| spellingShingle | Alexander Rosendahl Anet Vanaveski Liina Pilv-Toom Jānis Blumfelds Vija Siliņa Mette Brekke Tuomas Koskela Aurimas Rapalavičius Hans Thulesius Peter Vedsted Michael Harris General practitioners’ clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries Scandinavian Journal of Primary Health Care Cancer general practice primary health care early diagnosis geography |
| title | General practitioners’ clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries |
| title_full | General practitioners’ clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries |
| title_fullStr | General practitioners’ clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries |
| title_full_unstemmed | General practitioners’ clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries |
| title_short | General practitioners’ clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries |
| title_sort | general practitioners clinical decision making in patients that could have cancer a vignette study comparing the baltic states with four nordic countries |
| topic | Cancer general practice primary health care early diagnosis geography |
| url | https://www.tandfonline.com/doi/10.1080/02813432.2025.2451653 |
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