Primary care activity prior to cancer diagnosis in adolescents and young adults (PAPAYA)

Project Details

This project examined patients aged 18-39 years with a cancer diagnosis, stratifying cancers by site.  It examined GP activity in the two years before cancer diagnosis for different cancer sites and different types of GP activity to evaluate if potential opportunities for earlier diagnosis exist. It  examined whether patients with multiple GP consults in the year before cancer diagnosis differ by different patient factors e.g. age, sex, rurality, to determine if there are high-risk populations for recurrent presentations who may benefit from interventions to streamline diagnosis.

All patients aged 18-39 with a new diagnosis of cancer recorded in VCR and with a general practice (GP) encounter in a pre-specified period (e.g. 3 years) pre-diagnosis were identified for further analysis.

Patron ID: PAT1032_7

Project Lead: Dr Meena Rafiq

Research Outcomes

Adolescent and young adults (AYA) with underlying cancer often experience multiple General Practitioner (GP) consultations before they are referred to a specialist. Certain patient groups may be at higher risk of such events but evidence is lacking, particularly from Australia. This study, led by the VCCC Data Connect team, used Patron data to examine GP activity (GP consultations, prescriptions, blood test and imaging) prior to cancer diagnosis in an Australian cohort of AYAs and factors associated with multiple GP consultations in this period (including age, sex, socioeconomic status, regional or city location, culturally and linguistically diverse background and main spoken language).

We found that AYAs on average consulted their GP three times in the six months before cancer diagnosis with one in four AYAs consulting their GP four or more times in this period. AYAs living in regional Australia were more likely to have multiple GP consultations before diagnosis, and in AYAs aged 18-25 years, the most deprived patients were more likely to have multiple GP consults.

Our findings identified AYA patient groups at higher risk of multiple GP consultations before cancer diagnosis and at risk of having a prolonged diagnostic journey. These findings could help to inform policy and prioritise early diagnosis interventions focusing on these patient groups.

These findings have been presented at two international conferences and are being prepared for publication in a peer-review journal.