Abstract
OBJECTIVES: To describe the types of cancer identified in primary health care, their clinical presentation, management until diagnosis and delay in diagnosis. DESIGN: Descriptive study based on secondary information from medical records. SETTING: Two urban health care centres in Mallorca, Spain. PARTICIPANTS: Patients over 14 years old diagnosed with cancer between 1994 and 1998. MEASUREMENTS: Age, sex, location of tumour, symptoms, role of family doctor, specialist referral, care environment, time from first symptom to diagnosis, and stage of tumour. RESULTS: We identified 408 cancers. Mean age at diagnosis was 66.5 years (95% CI, 65.3-67.7); 237 (58.1%) were male. The most frequent tumours were colorectal, lung, prostate, breast and bladder, and the most common symptom was pain (33.1%; 95% CI, 28-38.3). The family doctor was involved in 63% of diagnoses (95% CI, 58.2-67.8). Mean delay from first symptom until diagnosis was 90 days, of which 26 were attributed to the patient and 55 to primary health care services. For colorectal, lung and prostate cancers, delay was shorter. The tumour was less advanced at diagnosis when family doctors were involved. CONCLUSIONS: Family doctors are involved in the diagnosis of most cancers. In colorectal, lung and prostate cancers, their contribution could improve prognosis. More studies are needed to confirm these findings.