{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T04:32:15Z","timestamp":1780893135455,"version":"3.54.1"},"reference-count":49,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Feature paper invited by Ms. Jennifer He with a 100% discount","award":["Feature paper invited by Ms. Jennifer He with a 100% discount"],"award-info":[{"award-number":["Feature paper invited by Ms. Jennifer He with a 100% discount"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal (GI) tract, predominantly driven by KIT or PDGFR\u03b1 oncogene mutations. Nonspecific symptoms contribute to diagnostic delays, with general practitioners (GPs) playing a pivotal role in early detection. However, studies on GIST-specific primary care pathways are limited. This study examines GP contacts, diagnoses, and prescribed drugs in primary care during the 12 months preceding GIST diagnosis. Methods: This case-control study utilized data from the Netherlands Cancer Registry and Nivel Primary Care Database. It included 294 GIST patients diagnosed between 2010 and 2020 and 576 matched cancer-free controls. GP contacts, diagnoses, and newly prescribed drugs were analyzed across two time intervals: 0\u20134 and 5\u201312 months prediagnosis. Statistical comparisons were conducted using the Wilcoxon rank-sum test and descriptive analyses. Results: GIST cases had a median of six GP contacts (IQR 4\u201311) in the 12 months prediagnosis versus three (IQR 2\u20136) for controls (p &lt; 0.05). Contacts increased 4 months before diagnosis, peaking 1 month prior. Common diagnoses in the 4-month interval included malignant neoplasms of the stomach (27.9%) and other digestive sites (27.6% and 11.2%), abdominal pain (9.5%), and iron deficiency anemia (9.5%). Newly prescribed drugs included proton pump inhibitors (13.9%) and osmotically acting laxatives (15.0%). Conclusions: This study highlights increased GP visits and specific reasons for these visits before GIST diagnosis. Future research should further examine GP records, not only through coded data but also unstructured data, and incorporate patient and GP perspectives to explore potential improvements in the diagnostic process.<\/jats:p>","DOI":"10.3390\/cancers17091391","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T20:11:48Z","timestamp":1745352708000},"page":"1391","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Prediagnostic General Practitioners\u2019 Pathway of Gastrointestinal Stromal Tumor Patients: A Real-World Data Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-4553","authenticated-orcid":false,"given":"Emily I.","family":"Holthuis","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"},{"name":"Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Slijkhuis","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"},{"name":"Nutrition and Disease Department, Wageningen University and Research (WUR), 6708 PB Wageningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7549-3338","authenticated-orcid":false,"given":"Winette T. A.","family":"van der Graaf","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"},{"name":"Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cas","family":"Drabbe","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Radboud Institute of Medical Innovation, Department of Primary and Community Care, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2303-3468","authenticated-orcid":false,"given":"Winan J.","family":"van Houdt","sequence":"additional","affiliation":[{"name":"Surgical Oncology Department, NKI-AVL\u2014Netherlands Cancer Institute\/Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7065-514X","authenticated-orcid":false,"given":"Yvonne M.","family":"Schrage","sequence":"additional","affiliation":[{"name":"Surgical Oncology Department, NKI-AVL\u2014Netherlands Cancer Institute\/Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2078-1206","authenticated-orcid":false,"given":"Tim C.","family":"Olde Hartman","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Radboud Institute of Medical Innovation, Department of Primary and Community Care, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7703-6250","authenticated-orcid":false,"given":"Annemarie","family":"Uijen","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Radboud Institute of Medical Innovation, Department of Primary and Community Care, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2989-2279","authenticated-orcid":false,"given":"Neeltje","family":"Steeghs","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"},{"name":"Department of Medical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Bos","sequence":"additional","affiliation":[{"name":"Netherlands Institute for Health Services Research (Nivel), 3513 CR Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1794-7407","authenticated-orcid":false,"given":"Marianne","family":"Heins","sequence":"additional","affiliation":[{"name":"Netherlands Institute for Health Services Research (Nivel), 3513 CR Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Husson","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands"},{"name":"Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Public Health, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.canep.2015.10.031","article-title":"Global epidemiology of gastrointestinal stromal tumours (GIST): A systematic review of population-based cohort studies","volume":"40","author":"Sandvik","year":"2016","journal-title":"Cancer Epidemiol."},{"key":"ref_2","unstructured":"WHO Classification of Tumours Editorial Board (2020). 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