How frequently do young people with potential cancer symptoms present in primary care?

Br J Gen Pract. 2011 May;61(586):e223-30. doi: 10.3399/bjgp11X572418.

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.

Aim: To determine how often teenagers and young adults consult, their reasons for doing so, and how often potential oncological symptoms ('alert' symptoms) appear.

Design and setting: Retrospective audit of consultations over 1 year. Three general medical practices in Scotland.

Method: 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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Early Detection of Cancer / methods*
  • Early Detection of Cancer / statistics & numerical data
  • Female
  • General Practice / statistics & numerical data
  • Humans
  • Male
  • Medical Audit
  • Neoplasms / diagnosis*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Retrospective Studies
  • Sex Factors
  • Young Adult