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Early diagnosis is a key factor in improving the outcomes of cancer patients. A greater understanding of the pre-diagnostic patient pathways is vital yet, at present, research in this field lacks consistent definitions and methods. As a consequence much early diagnosis research is difficult to interpret. A consensus group was formed with the aim of(More)
OBJECTIVE To identify and quantify symptoms of ovarian cancer in women in primary care. DESIGN Case-control study, with coding of participants' primary care records for one year before diagnosis. SETTING 39 general practices in Devon, England. PARTICIPANTS 212 women aged over 40 with a diagnosis of primary ovarian cancer, 2000-7; 1060 controls matched(More)
BACKGROUND Late diagnosis of lung cancer can impact on survival rates. Patients delay seeking help for a number of reasons. This study explored symptom appraisal and help-seeking decisions among patients referred to specialist respiratory services with symptoms suggestive of lung cancer. METHODS In-depth qualitative interviews with patients as soon as(More)
OBJECTIVE To measure the risk of colorectal cancer and adenoma with new onset rectal bleeding reported to primary care. DESIGN Cohort study. SETTING A rural general practice in the United Kingdom. PARTICIPANTS Patients aged 45 or more with new onset rectal bleeding, irrespective of other symptoms. MAIN OUTCOME MEASURES Percentage of participants in(More)
BACKGROUND AND PURPOSE Development of stroke networks is critical to bringing guideline-driven stroke care to rural, underserved areas. METHODS A Web-based telestroke tool, REACH, was developed to provide a foundation for a rural stroke network that delivered acute stroke consults 24 hours per day 7 days per week to 8 rural community hospitals in Georgia.(More)
BACKGROUND This paper reviews the background to five primary care case-control studies, collectively known as the CAPER studies (Cancer Prediction in Exeter). These studies, on colorectal, lung, prostate and brain tumours, sought to identify the particular features of cancer as reported to primary care. They also sought to quantify the risk of cancer for(More)
BACKGROUND The relationship between the diagnostic interval and mortality from colorectal cancer (CRC) is unclear. This association was examined by taking account of important confounding factors at the time of first presentation of symptoms in primary care. METHODS A total of 268 patients with CRC were included in a prospective, population-based study in(More)
Most colorectal cancers are diagnosed after the onset of symptoms. However, the risk of colorectal cancer posed by particular symptoms is largely unknown, especially in unselected populations like primary care. This was a population-based case-control study in all 21 general practices in Exeter, Devon, UK, aiming to identify and quantify the prediagnostic(More)
BACKGROUND The primary aim was to use routine data to compare cancer diagnostic intervals before and after implementation of the 2005 NICE Referral Guidelines for Suspected Cancer. The secondary aim was to compare change in diagnostic intervals across different categories of presenting symptoms. METHODS Using data from the General Practice Research(More)
BACKGROUND Colorectal cancer can present in a variety of ways, and with any of several symptoms. Different referral routes from primary to secondary care cater for these different presentations. The route that has received most investment in the UK National Health Service is the 2-week clinic, but the proportions of patients taking this and other routes to(More)