Abstract
Background: Patients with cancer often consult their general practitioner (GP) prior to the diagnosis. Thus, actions taken by the GP are crucial for optimisation of cancer care. This study aimed to investigate the association between cancer patient’s travel distance to the first specialised diagnostic investigation and the GP’s diagnostic strategy and satisfaction with the waiting time and the availability of diagnostic investigations.Method: This combined questionnaire- and registry-based study included incident cancer patients diagnosed in the last six months of 2016 where the GP had been involved in the diagnostic process of the patients prior to their diagnosis of cancer (n=3,455). The patient’s travel distance to the first specialised diagnostic investigation was calculated by ArcGIS Network Analyst. The diagnostic strategy of the GP and the GP’s satisfaction with the waiting times and the available investigations were assessed from GP questionnaires. Results: The patient’s travel distance to the first specialised diagnostic investigation was not associated with the diagnostic strategy of the GP. However, when the GP did not suspect cancer or serious illness, a tendency was seen that longer travel distance to the first specialised diagnostic investigation increased the likelihood of the GP using ’wait-and-see’ approach and ’medical treatment’ as diagnostic strategies. The GPs of patients with travel distance longer than 49 kilometres to the first specialised diagnostic investigation were more likely to report dissatisfaction with the waiting time for requested diagnostic investigations (PRR: 1.98, 95% CI: 1.20-3.28).Conclusion: A tendency to use ‘wait-and-see’ and ‘medical treatment’ were more likely in GPs of patients with long travel distance to the first diagnostic investigation when the GP did not suspect cancer or serious illness. Long distance was associated with higher probability of GP dissatisfaction with the waiting time for diagnostic investigations.