title: How frequently do young people with potential cancer symptoms present in primary care?
abstract: BACKGROUND
  Although uncommon in teenagers and young adults, cancer is the leading cause of non-accidental death in those aged 15-24 years. A prolonged period to cancer diagnosis in this cohort is reported and thought to be a consequence of the rarity of cancer in this age group, together with the complexity of presenting symptoms. Although diagnostic delay is perceived to be a problem for teenagers and young adults with cancer, little research has focused on their use of primary care services.
  
  
  OBJECTIVE
  To determine how often teenagers and young adults consult, their reasons for doing so, and how often potential oncological symptoms ('alert' symptoms) appear.
  
  
  METHODS
  Retrospective audit of consultations over 1 year. Three general medical practices in Scotland.
  
  
  METHODS
  Medical records were examined for 2326 teenagers and young adults. Date of birth, sex, and free-text relating to the consultation were recorded and coded according to an agreed coding system; symptoms of potential oncological significance were coded as alert symptoms.
  
  
  RESULTS
  A total of 1659 teenagers and young adults (71.3% of registered patients) attended their GP at least once. Females attended more frequently than males (P < 0.001), and older females more frequently than younger females (P < 0.001). Males exhibited no association between consultation frequency and age. The main reasons for consultation were pregnancy/contraception (15.8%) and infection (15.7%). Alert symptoms were uncommon, (reported in 4.0% of all consultations; 276 alert symptoms in 179 patients), and were not associated with age or sex. The most common alert symptoms were unexplained pain (34.8%), unexplained fatigue (14.5%), and lumps (13.4%). Two benign tumours were detected.
  
  
  CONCLUSIONS
  A high proportion of teenagers and young adults consult their GP. Alert symptoms are uncommon and generally occur in isolation. More research is required to confirm these findings in a larger cohort and to examine how GPs respond to such alert symptoms.
authors.affiliation: National Cancer Research Institute, Teenage & Young Adult Clinical Studies Group, University College Hospitals London NHS Foundation Trust, London, UK.
authors.forename: Lorna A
authors.initials: LA
authors.lastname: Fern
authors.forename: Christine
authors.initials: C
authors.lastname: Campbell
authors.forename: Tim Ob
authors.initials: TO
authors.lastname: Eden
authors.forename: Robert
authors.initials: R
authors.lastname: Grant
authors.forename: Ian
authors.initials: I
authors.lastname: Lewis
authors.forename: Una
authors.initials: U
authors.lastname: Macleod
authors.forename: David
authors.initials: D
authors.lastname: Weller
authors.forename: Jeremy
authors.initials: J
authors.lastname: Whelan
mesh_terms: D000293:Adolescent; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008485:Medical Audit; D009369:Neoplasms / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult