Does good practice quality equate to earlier cancer stage at diagnosis?

Abstract

The early diagnosis of cancer is a priority within the UK, with GPs being identified as playing a key role. The aim of this research was to look at the relationship between GP practice quality and cancer stage at diagnosis, for breast and colorectal cancer, within the North East of England.
This was done by utilising existing healthcare databases, with data being obtained from the National Health Service (NHS) information centre, public health observatories and Northern and Yorkshire Cancer Registry and Information Service. Patient data was from between 2006-2008 with n = 13,610 cases of breast cancer and n = 11,606 cases of colorectal cancer. The data was combined and a range of analyses conducted to investigate the potential relationship between GP practice quality and a patient’s cancer stage at diagnosis.
For breast cancer there was a significant relationship between GP practice quality and cancer stage in both multi-level and base outcome regression analyses. A range of specific variables, many of which were related to patient experience, were found to have a significant effect upon breast cancer stage. Patient age and level of income were also found to have a significant effect upon breast cancer stage.
For colorectal cancer no association was found in multi-level analysis but a significant association was found between cancer stage and variables related to patient experience, such as a patient’s ability to see a doctor within two days. Patients of working age (18-64) compared to retirement age (65+), were found to be more likely to have a more advanced cancer stage at diagnosis, as were patients with low income.
In summary, significant associations were found between measures of GP practice quality and patient cancer stage at diagnosis, specifically GP variables related to patient experience. This association suggests that higher quality of practice may increase the likelihood of being diagnosed with earlier stage of cancer. The limitations of this research are highlighted and directions for future research projects and healthcare policy are discussed and outlined.