title: Direct-access to abdominal ultrasonic investigation from general practice—the role in earlier cancer diagnosis.
abstract: BACKGROUND
  Abdominal ultrasound (US) is a safe and low-cost diagnostic tool for various abdominal symptoms. Direct-access to US from general practice has been suggested as a feasible option to promote earlier cancer diagnosis because abdominal cancer often presents with non-specific and vague symptoms, and the exact location may be difficult to identify on the basis of symptoms alone.
  
  
  OBJECTIVE
  To describe patterns of use and cancer prevalence in referred patients when providing Danish GPs with direct-access to hospital-based US.
  
  
  METHODS
  In an observational study, GPs were given the opportunity to either refer patients directly to US or through a waiting-list at Vejle Regional Hospital in Denmark; 701 patients were included between 1 August 2009 and 31 January 2010. Data were retrieved from the local Radiology Information System, GP referrals and the Danish Cancer Registry.
  
  
  RESULTS
  GPs referred 60% of all patients to direct-access US. Cancer was diagnosed in 19 (2.7%) of the referred patients within 6 months after the US investigation. US gave rise to the suspicion of cancer in 11 of these patients (57.9%); 10 of these had been referred to direct-access US. At least one non-malignant diagnosis resulted from US in 59.5% of the cases, while 37.8% of the cases had no final diagnosis.
  
  
  CONCLUSIONS
  The findings in this study might indicate that GPs refer patients assessed to have a higher risk of cancer through direct-access US. The finding was statistically non-significant, and further research is required to confirm this result.
authors.affiliation: Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care (CaP) and Section of General Medical Practice, Department of Public Health, Aarhus University, Aarhus and mads.ingeman@feap.dk.
authors.forename: Mads Lind
authors.initials: ML
authors.lastname: Ingeman
authors.affiliation: Vejle Regional Hospital, Lillebaelt Hospital, Vejle, Region of Southern Denmark, Denmark.
authors.forename: Tina E
authors.initials: TE
authors.lastname: Ormstrup
authors.affiliation: Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care (CaP) and.
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D055088:Early Detection of Cancer; D005260:Female; D058006:General Practice; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D015995:Prevalence; D012017:Referral and Consultation; D014463:Ultrasonography; D014850:Waiting Lists; D055815:Young Adult
keywords: Denmark; diagnosis; diagnostic imaging; general practice; neoplasms; ultrasonography.