Patient–doctor continuity and diagnosis of cancer: electronic medical records study in general practice.
Approach to Improving Safety
Setting of Care
A delayed or missed diagnosis of cancer can have profound ramifications for patients. This retrospective cohort study in England sought to determine whether patient–doctor continuity in the ambulatory setting affected the time to diagnosis or referral for three common cancers. The researchers used a large reliable dataset for patients with a diagnosis of breast, colorectal, or lung cancer between January 2000 and December 2009. They searched for any relevant cancer symptoms or signs up to 12 months prior to the diagnosis and calculated patient–doctor continuity for up to 2 years before diagnosis. The measured associations appeared small and inconsistent, suggesting no clinically important differences. The longest delays for diagnosis occurred after patients had been referred for consultation, indicating that future studies should focus on the process of care between referral and diagnosis.