[Intervention of the family physician in the diagnosis of cancer].
OBJECTIVE
To find the intervention of family doctors (FD) in diagnosing tumour pathology.


METHODS
Retrospective descriptive study.


METHODS
Urban primary care centre.


METHODS
Patients over 14 diagnosed with cancer.


METHODS
Selection of patients from the computerised records between November 1989 and March 1997. Review of clinical histories, analysing: 1. Personal details, 2. Type of cancer, 3. Intervention of the FD in the diagnosis, 4. Symptom of initial consultation, 5. Further tests requested by FD, 6. Interval between consultation and diagnosis, 7. Survival and 8. interval between diagnosis and death. FD intervention in diagnosis was evaluated: 1. Impossible intervention, 2. No intervention, with suspect signs not valued (SSNV) or with suspect signs valued (SSV), 3. Diagnostic intervention, incomplete (Iin) or complete (Ico).


RESULTS
438 tumours were detected: in 256 men (59%) and 171 women (41%). The most common kind in men was lung cancer (46 cases, 17%), and in women breast cancer (59 cases, 34%). In 233 cases (53%) the intervention of the FD was impossible. In 29 cases (6.5%) the FD's intervention was nil (15 cases with SSNV, 14 cases with SSV). Of the 174 cases (39.6%) in which the FD intervened, full diagnosis was made in 40% (69 cases). The mean of the interval between the first consultation and the diagnosis was significantly less when FD intervention existed, at 1.95 months (CI, 0.63-1.06) in Ico and 2.9 months (CI, 0.51-2.19) in Iin, than when there was no intervention, with delays of 5.58 months (CI, 1.46-3.53) with SSNV and 10.5 months (CI, 8.45-12.54) with SSV (p = 0.000).


CONCLUSIONS
The family doctor can play an important part in cancer diagnosis. His/her active intervention can reduce the interval between consultation and diagnosis.
Unidad Docente de Medicina Familiar, CAP Terrassa Nord, Barcelona.
E
E
Simó Cruzet
M M
MM
Ureña Tapia
M
M
Vernet Vernet
M J
MJ
Sender Palacios
P
P
Larrossa Sáez
E
E
Jovell Fernández
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis; D015179:Colorectal Neoplasms / Q000175:diagnosis; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D010819:Physician's Role; D010821:Physicians, Family; D011471:Prostatic Neoplasms / Q000175:diagnosis; D012189:Retrospective Studies; D012737:Sex Factors