The diagnosis of cancer in the "roar" of potential cancer symptoms of patients in primary health care. Research by means of the computerised journal.
OBJECTIVE
To describe the diagnostic work-up pattern in primary health care, aiming, with as few diagnostic activities as possible, to identify a number of malignancies among patients presenting with various symptoms, where a malignancy may be a differential diagnosis.


METHODS
Survey of computerised journals. Diagnostic codes (ICD-9 system in primary health care) relating to signs, symptoms or diagnosis were selected where colorectal, pulmonary, breast and prostate malignancies might be differential diagnoses. All diagnostic actions were analysed.


METHODS
6812 patients over 30 years of age from four health centres who were recorded for a total of 14455 selected diagnostic codes.


RESULTS
The diagnostic actions resulted in 1426 X-ray or sonographic investigations, 340 endoscopies, 16203 haematology, clinical chemistry or microbiology tests and 667 referrals to specialists. Forty-nine malignancies were diagnosed at the primary health care centres, while 10 malignancies were classified as "missed". The frequency of faecal-occult blood tests performed was low while that of ESR and pulmonary X-ray examinations was high.


CONCLUSIONS
The task for a GP identifying one or two undiagnosed malignancies per year of the four most common types among all the non-neoplastic ailments, and with as little diagnostic activity as possible, is a professional challenge to be scrutinised continuously.
Månsson
J
J
Primary Health Care Centre of Kungsbacka, Sweden. jorgen@huslakarna-kungsbacka.se
Marklun
B
B
Hultborn
R
R
D000043:Abstracting and Indexing; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D003954:Diagnostic Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D011320:Primary Health Care / Q000379:methods*; D012107:Research Design; D013548:Sweden