{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T12:40:13Z","timestamp":1759236013675,"version":"3.44.0"},"reference-count":32,"publisher":"Royal College of General Practitioners","issue":"759","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"accepted":{"date-parts":[[2024,12,9]]},"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Oesophagogastric (OG) cancer-associated symptoms are common in primary care, but most research has focused on patients with a confirmed OG cancer diagnosis, rather than those presenting with symptoms for the first time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To examine diagnostic testing patterns for upper gastrointestinal (GI) symptoms linked to OG cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and setting<\/jats:title>\n                  <jats:p>A retrospective cohort study was undertaken, which used a linked primary care database. It included de-identified patients aged &gt;55 years who presented with symptoms suggestive of OG cancer between 2008 and 2022.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>The study analysed the proportion of patients who underwent pathology, imaging, referral, upper GI endoscopy, or a test of treatment. Differences across socioeconomic groups were also examined, along with the proportion of patients diagnosed with OG cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study cohort consisted of 44 402 patients, of whom 126 (0.3%) were diagnosed with OG cancer within 12 months of presentation. Reflux was the most common symptom (57%), followed by nausea (11%). Patients aged \u226575 years were less likely to be investigated or referred than those aged 56\u201364 years (odds ratio [OR] 0.59, 95% confidence interval [CI] = 0.56 to 0.62, <jats:italic>P<\/jats:italic>&lt;0.001). Those from less disadvantaged areas were 1.4 times more likely to be investigated than people from the most disadvantaged areas (OR 1.44, 95% CI = 1.36 to 1.53, <jats:italic>P<\/jats:italic>&lt;0.001). Patients on test-of-treatment medications were less likely to receive further investigation (OR 0.66, 95% CI = 0.63 to 0.69, <jats:italic>P<\/jats:italic>&lt;0.001). Multiple symptoms and visits increased the likelihood of investigation (OR 2.77, 95% CI = 2.55 to 3.00, <jats:italic>P<\/jats:italic>&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Significant variations in diagnostic testing could contribute to disparities in OG cancer outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.3399\/bjgp.2024.0621","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T11:25:22Z","timestamp":1743593122000},"page":"e686-e694","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of diagnostic testing for oesophagogastric cancer-related symptoms in Australian primary care: a retrospective cohort study"],"prefix":"10.3399","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6772-0649","authenticated-orcid":false,"given":"Shaoke","family":"Lei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2631-1002","authenticated-orcid":false,"given":"Brent","family":"Venning","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5690-9542","authenticated-orcid":false,"given":"Alison","family":"Pearce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1007-1382","authenticated-orcid":false,"given":"Alex","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5274-6336","authenticated-orcid":false,"given":"Jon","family":"Emery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1987","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"issue":"9","key":"2025093005100812000_75.759.e686.1","doi-asserted-by":"crossref","first-page":"446","DOI":"10.5694\/mja2.52287","article-title":"Symptomatic cancer diagnosis in general practice: a critical perspective of current guidelines and risk assessment tools","volume":"220","author":"Venning","year":"2024","journal-title":"Med J Aust"},{"key":"2025093005100812000_75.759.e686.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2013.212"},{"key":"2025093005100812000_75.759.e686.3","unstructured":"Britt H Miller GC Bayram C (2016) A decade of Australian general practice activity 2006\u201307 to 2015\u201316, accessed. https:\/\/ses.library.usyd.edu.au\/bitstream\/handle\/2123\/15482\/9781743325162_ONLINE.pdf. 24 Jul 2025."},{"key":"2025093005100812000_75.759.e686.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.neo.2017.11.005"},{"key":"2025093005100812000_75.759.e686.5","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2014.634"},{"issue":"9","key":"2025093005100812000_75.759.e686.6","first-page":"621","article-title":"The management of unresolved gastrointestinal symptoms in Australian general practice","volume":"44","author":"Gordon","year":"2015","journal-title":"Aust Fam Physician"},{"key":"2025093005100812000_75.759.e686.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2008.02.020"},{"key":"2025093005100812000_75.759.e686.8","unstructured":"Australian Commission on Safety and Quality in Health Care (ACSQHC) (2021) The Fourth Australian Atlas of Healthcare Variation (ACSQHC, Sydney) In, pp 247\u2013300. 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