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    Advice to consult a general medical practitioner in Western Australia: could it be cancer?

    Access Status
    Fulltext not available
    Authors
    Jiwa, Moyez
    Halkett, Georgia
    Arnet, Hayley
    Smith, Marthe
    McConigley, Ruth
    Lim, D.
    Bulsara, M.
    Islam, A.
    Date
    2009
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Jiwa, Moyez and Halkett, Georgia and Arnet, Hayley and Smith, Marthe and McConigley, Ruth and Lim, David and Bulsara, Max and Islam, Akil. 2009. Advice to consult a general medical practitioner in Western Australia: could it be cancer? Quality in Primary Care. 17 (1): pp. 23-29.
    Source Title
    Quality in Primary Care
    ISSN
    14791072
    Faculty
    School of Nursing and Midwifery
    Faculty of Health Sciences
    WA Centre for Cancer and Palliative Care (WACCPC)
    Remarks

    This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Quality in Primary Care following peer review. The definitive version, Quality in Primary Care 2009; 17 (1): pp. 23-29, is available online at http://www.ingentaconnect.com/content/rmp/qpc/

    Copyright © 2009 Radcliffe Publishing.

    URI
    http://hdl.handle.net/20.500.11937/45855
    Collection
    • Curtin Research Publications
    Abstract

    Background: Many people will consult a medical practitioner about lower bowel symptoms, and the demand for access to general practitioners (GPs) is growing. We do not know if people recognise the symptoms of lower bowel cancer when advising others about the need to consult a doctor. A structured vignette survey was conducted in Western Australia. Method: Participants were recruited from the waiting rooms at five general practices. Respondents were invited to complete self-administered questionnaires containing nine vignettes chosen at random from a pool of 64 based on six clinical variables. Twenty-seven vignettes described high-risk bowel cancer scenarios. Respondents were asked if they would recommend a medical consultation for the case described and whether they believed the scenario was a cancer presentation. Logistic regression was used to estimate the independent effects of each variable on the respondent's judgement. Two-hundred and sixty-eight completed responses were collected over eight weeks.Results: The majority (61%) of respondents were female, aged 40 years and older. A history of rectal bleeding, six weeks of symptoms, and weight loss independently increased the odds of recommending a consultation with a medical practitioner by a factor of 7.64, 4.11 and 1.86, respectively. Most cases that were identified as cancer (75.2%) would not be classified as such on current research evidence. Factors that predict recognition of cancer presentations include rectal bleeding, weight loss and diarrhoea. Conclusion: Within the limitation of this study, respondents recommended that most symptomatic people present to their GP. However, we report no evidence that they recognised a cancer presentation, and duration of symptoms was not a significant variable in this regard. Cases that were identified as 'cancer' could not be classified as high risk on the available evidence.

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