{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:07:40Z","timestamp":1765609660454,"version":"3.37.3"},"reference-count":23,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,7,24]]},"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Determine how general practitioners (GPs) manage patients with cancer symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>GPs reviewed 24 video-vignettes and case notes on patients with cancer symptoms and indicated whether they would refer the patient and\/or prescribe medication, and\/or undertake further investigation. According to available guidelines, all cases warranted a referral to a specialist or further investigations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Australian primary care sector.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>102 practising GPs participated in this study, including trainees.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>The research was part of a larger randomised controlled trial testing a referral pro forma; however, this paper reports on management decisions made throughout the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>This paper reports on how the participants would manage the patients depicted in each vignette.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In more than one-in-eight cases, the patient was not investigated or referred. Patient management varied significantly by cancer type (p&lt;0.001). For two key reasons, colorectal cancer was the chosen referent category. First, it represents a prevalent type of cancer. Second, in this study, colorectal cancer symptoms were managed in a similar proportion of options\u2014that is, prescription, referral or investigation. Compared with vignettes featuring colorectal cancer participants were less likely to manage breast, bladder, endometrial, and lung cancers with a \u2018prescription only\u2019 or \u2018referral only\u2019 option. They were less likely to manage prostate cancer with a \u2018prescription only\u2019, yet more likely to manage it with a \u2018referral with investigation\u2019. With regard to pancreatic and cervical cancers, participants were more likely to manage these with a \u2018referral only\u2019 or a \u2018referral with investigation\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Some patients may receive a delayed cancer diagnosis, even when they present with typical cancer symptoms to a GP who can access relevant diagnostic tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>ACTRN12611000760976.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2015-008525","type":"journal-article","created":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T01:19:59Z","timestamp":1442279999000},"page":"e008525","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["How do general practitioners manage patients with cancer symptoms? A video-vignette study"],"prefix":"10.1136","volume":"5","author":[{"given":"Moyez","family":"Jiwa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingqiong","family":"Meng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"O'Shea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parker","family":"Magin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Dadich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3663-0138","authenticated-orcid":false,"given":"Vinita","family":"Pillai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,9,14]]},"reference":[{"key":"2024051514180237000_5.9.e008525.1","first-page":"698","article-title":"The role of general practice in cancer care","volume":"37","author":"Mitchell","year":"2008","journal-title":"Aust Fam Physician"},{"key":"2024051514180237000_5.9.e008525.2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp11X588231"},{"key":"2024051514180237000_5.9.e008525.3","unstructured":"Health Workforce Australia. Doctors in focus. Adelaide, SA: Health Workforce Australia, 2012."},{"key":"2024051514180237000_5.9.e008525.4","unstructured":"Department of Health (United Kingdom). Direct Access to Diagnostic Tests for Cancer. Best Practice Referral Pathways for General Practitioners. April 2012. https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/216503\/dh_133511.pdf (accessed 9 Mar 2015)."},{"key":"2024051514180237000_5.9.e008525.5","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp11X572283"},{"key":"2024051514180237000_5.9.e008525.6","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp10X515304"},{"key":"2024051514180237000_5.9.e008525.7","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp12X616292"},{"key":"2024051514180237000_5.9.e008525.8","first-page":"1712","article-title":"General practice and early cancer diagnosis","volume":"173","author":"Vedsted","year":"2011","journal-title":"Ugeskr Laeger"},{"key":"2024051514180237000_5.9.e008525.9","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.socscimed.2014.06.030","article-title":"How might healthcare systems influence speed of cancer diagnosis: a narrative review","volume":"116","author":"Brown","year":"2014","journal-title":"Soc Sci Med"},{"key":"2024051514180237000_5.9.e008525.10","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp11X613160"},{"key":"2024051514180237000_5.9.e008525.11","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp10X515412"},{"key":"2024051514180237000_5.9.e008525.12","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp14X680509"},{"key":"2024051514180237000_5.9.e008525.13","unstructured":"NICE (National Institute for Health and Clinical Excellence). Referral guidelines for suspected cancer. London: NICE (National Institute for Health and Clinical Excellence), Apr 2011. Report No.: Contract No.: 27."},{"key":"2024051514180237000_5.9.e008525.14","unstructured":"Britt H , Miller GC , Henderson J , et al . General practice activity in Australia 2011\u201312. Sydney, NSW: University of Sydney, 2012 GEP 31."},{"key":"2024051514180237000_5.9.e008525.15","unstructured":"AIHW (Australian Institute of Health and Welfare). Medical workforce 2011. Canberra, ACT: AIHW (Australian Institute of Health and Welfare), 2013 HWL 49."},{"key":"2024051514180237000_5.9.e008525.16","unstructured":"General Practice Education and Training Limited. Annual report. Canberra, ACT: General Practice Education and Training Limited, 2012."},{"key":"2024051514180237000_5.9.e008525.17","unstructured":"PHCRIS (Primary Health Care Research & Information Service). Fast facts: GP numbers in Australia, 1999\u20132000 to 2010\u201311 [Website]. Bedford Park, SA: PHCRIS (Primary Health Care Research & Information Service), 2013 (cited 29 May 2013). http:\/\/www.phcris.org.au\/fastfacts\/fact.php?id=6775"},{"key":"2024051514180237000_5.9.e008525.18","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2010.543496"},{"key":"2024051514180237000_5.9.e008525.19","first-page":"70","article-title":"Disparities in cancer outcomes in regional and rural Australia","volume":"31","author":"Heathcote","year":"2007","journal-title":"Cancer Forum"},{"key":"2024051514180237000_5.9.e008525.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7340.783"},{"key":"2024051514180237000_5.9.e008525.21","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2008.084285"},{"key":"2024051514180237000_5.9.e008525.22","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmn071"},{"key":"2024051514180237000_5.9.e008525.23","unstructured":"Delayed diagnosis of cancer. Thematic review. National Patient Safety Agency. Royal College of General Practitioners. UK. 2010. http:\/\/www.nrls.npsa.nhs.uk\/resources\/?EntryId45=69894 (accessed 23\/06\/2015)."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2015-008525","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T21:32:50Z","timestamp":1715808770000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2015-008525"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9]]},"references-count":23,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2015,9,14]]},"published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1136\/bmjopen-2015-008525"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2015-008525","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2015,9]]}}}