Patterns of diagnostic testing for OG cancer related symptoms including cost analysis of testing
Project Details
Symptoms associated with cancer, referred to as 'cancer symptoms,' often share characteristics with non-cancer conditions commonly seen in general practice. The diversity of potential diagnoses in primary care, combined with low cancer prevalence, can result in significant testing variations, the full extent and implications of which remain unclear. This project aims to enhance our understanding of diagnostic testing patterns for common upper gastrointestinal symptoms associated with oesophagogastric cancer in Victorian general practice.
Patron ID: PAT1032_3 / PAT1062
Project Lead: Prof Jon Emery
Project Outcome
This project examined how general practitioners (GPs) investigate symptoms that may be related to oesophagogastric (OG) cancer, analysing data from 44,402 patients aged 55 and older who presented to general practices in Victoria between 2008 and 2022. By linking PATRON data with the Victorian Cancer Registry and the Victorian Admitted Episodes Dataset, the study uncovered important insights into diagnostic patterns and healthcare disparities.
Although OG cancer is relatively uncommon, affecting only 0.28 percent of symptomatic patients within 12 months, the research identified significant inequities in diagnostic testing. Patients aged 75 and above were 40 percent less likely to be investigated, despite having a higher risk of cancer. Likewise, individuals from socioeconomically disadvantaged areas were much less likely to receive specialist referrals or endoscopy compared to those from more advantaged communities.
Investigation patterns varied considerably depending on the symptom. Nearly half of the patients who presented with weight loss or anaemia had no recorded investigation, representing potential missed opportunities for earlier diagnosis.
This work underscores the careful balance GPs must maintain between conducting thorough investigations and avoiding unnecessary testing. It also highlights the importance of ensuring that all patients receive equitable care, regardless of age or socioeconomic background.
Research Publications
Patterns of diagnostic testing for oesophagogastric cancer-related symptoms in Australian primary care: a retrospective cohort study. Shaoke Lei, Brent Venning, Alison Pearce, Alex Lee, Jon Emery. British Journal of General Practice 2025; 75 (759): e686-e694 https://doi.org/10.3399/BJGP.2024.0621
Variations in the Investigation of Colorectal Cancer-related Symptoms in Australian Primary Care https://bjgp.org/content/early/2025/12/03/BJGP.2025.0619
Diagnostic testing patterns for lung cancer-related symptoms in primary care: a retrospective cohort study https://bmjopenrespres.bmj.com/content/12/1/e003337
Patterns of Diagnostic Testing for Oesophagogastric Cancer-Related Symptoms in Australian General Practice. https://doi.org/10.3399/BJGP.2024.0621
Lei S, Venning B, Pearce A, Emery J. Variations in the investigation of colorectal cancer-related symptoms in Australian primary care: a retrospective cohort study. BJGP February 2026; DOI: https://doi.org/10.3399/BJGP.2025.0619
Venning B, Lei S, Pearce A, Lee A, Emery JD. Diagnostic testing patterns for lung cancer-related symptoms in primary care: a retrospective cohort study. BMJ Open Respiratory Research. 2025;12:e003337. https://doi.org/10.1136/bmjresp-2025-003337