Early diagnosis of abdominal cancer in general practice - a cohort study

Cancer is a leading cause of death. General practitioners (GPs) must confront the professional challenge that among many patients with possible cancer symptoms, only a handful actually has cancer. Early diagnosis is generally considered decisive for a good prognosis. The relationship between abdominal symptoms and cancer needs to be clarified and will be studied in the present cohort study. Our research takes place in general practice surgeries and is based on real patients, with six months prospective recording of new cases of cancer and data related to these patients. Our research will try to benefit from collaboration in the CA-PRI network (The Cancer and Primary Care Research International Network), that aims to promote international research collaboration about cancer in primary care.

Objective: We want to investigate the importance and impact of symptoms, findings, supplementary investigation and the GP's degree of suspicion of cancer when abdominal symptoms are presented in primary care. Previous studies on early diagnosis of cancer have shown some symptoms to be valid but unspecific in relation to different forms of cancer. Through better empirical clinical-epidemiological data we hope to suggest improved diagnostic strategies for the GP towards the recognition of different forms of abdominal cancer like colorectal cancer, ovarian cancer, bladder cancer and others. Power calculations suggest sufficient power to obtain relevant data.

Method and material: We want to do a cohort study including approximately 110-120 000 consecutively consulting patients in general practice. Through international collaboration around 600 GPs will be recruited to register all patients consulting during ten workdays within a period of one month. All forms and guidelines will be printed in Norway and distributed from The University of Tromsø to the international collaborators. Data will be treated electronically with manual surveillance in Tromsø.