{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:37:48Z","timestamp":1792611468775,"version":"4.5.0"},"reference-count":19,"publisher":"Royal College of General Practitioners","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"accepted":{"date-parts":[[2025,10,1]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The urgent-referral Cancer Patient Pathway for Non-Specific Symptoms and Signs of Cancer (NSSC-CPP) was introduced in Denmark in 2012 to reduce delays in cancer diagnoses. In Region Zealand, it includes direct referral from GPs to contrast-enhanced computed tomography of thorax, abdomen, and pelvis (ceCT-TAP). In 2013, the NSSC-CPP cancer prevalence was 20%, but easy access to computed tomography (CT) may change referral patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine cancer prevalence, diagnostic accuracy of ceCT-TAP, and changes in NSSC-CPP referral patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>Retrospective cohort study conducted in Region Zealand, Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We included patients with non-specific symptoms or signs of cancer who were referred by GPs between 1 July and 31 December 2019. Primary endpoints were cancer prevalence and diagnostic accuracy of ceCT-TAP. Secondary endpoints were cancer types, referral trends between 2012 and 2019, and prevalence of GP-reported symptoms and clinical findings. Patients were followed up until cancer diagnosis or up to 12 months after ceCT-TAP, whichever came first.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 729 referrals were recorded, a five-fold increase compared with 140 referrals in the same period of 2013. Malignancy was diagnosed in 95 (13%) patients. Twelve patients had a false-negative ceCT-TAP result, yielding a negative likelihood ratio (LR) for malignancy of 0.15.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite a five-fold increase in GP referrals for ceCT-TAP since 2012, it remains an important diagnostic tool, identifying malignancy in one in seven patients. However, as the LR- was &gt;0.10, a normal ceCT-TAP does not convincingly rule out cancer and should not stand alone as the only decision-support tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgpo.2025.0077","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T12:00:21Z","timestamp":1762344021000},"page":"BJGPO.2025.0077","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic accuracy of computed tomography in patients with non-specific symptoms of cancer referred directly from general practice: a retrospective follow-up study"],"prefix":"10.3399","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2449-1702","authenticated-orcid":false,"given":"Mads","family":"R\u00f8mer Sk\u00f8tt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9314-2336","authenticated-orcid":false,"given":"Rawia Farah Gedde","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2955-0593","authenticated-orcid":false,"given":"Rudina Balliu","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne","family":"Sandstr\u00f8m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine Chabert","family":"Olesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1231-9209","authenticated-orcid":false,"given":"Uffe","family":"Bodtger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"2026102105001010000_10.3.BJGPO.2025.0077.1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-015-1317-7"},{"key":"2026102105001010000_10.3.BJGPO.2025.0077.2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-14-636"},{"key":"2026102105001010000_10.3.BJGPO.2025.0077.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.293.6541.245"},{"key":"2026102105001010000_10.3.BJGPO.2025.0077.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-032019"},{"key":"2026102105001010000_10.3.BJGPO.2025.0077.5","unstructured":"National Institute for Health and Care Excellence 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