Harris, MichaelFrey, PeterEsteva, MagdalenaGasparovic Babic, SvjetlanaMarzo-Castillejo, MercePetek, DavorinaPetek Ster, MarijaThulesius, Hans2024-07-112024-07-112017Harris M, Frey P, Esteva M, Gasparovic Babic S, Marzo-Castillejo M, Petek D, et al. How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes. Scand J Prim Health Care. 2017;35(1):27-34. Epub 2017 Mar 6.0281-3432http://hdl.handle.net/20.500.13003/10980http://hdl.handle.net/20.500.12105/20390Objective: European cancer survival rates vary widely. System factors, including whether or not primary care physicians (PCPs) are gatekeepers, may account for some of these differences. This study explores where patients who may have cancer are likely to present for medical care in different European countries, and how probability of presentation to a primary care clinician correlates with cancer survival rates. Design: Seventy-eight PCPs in a range of European countries assessed four vignettes representing patients who might have cancer, and consensus groups agreed how likely those patients were to present to different clinicians in their own countries. These data were compared with national cancer survival rates. Setting: A total of 14 countries. Subjects: Consensus groups of PCPs. Main outcome measures: Probability of initial presentation to a PCP for four clinical vignettes. Results: There was no significant correlation between overall national 1-year relative cancer survival rates and the probability of initial presentation to a PCP (r=-0.16, 95% CI-0.39 to 0.08). Within that there was large variation depending on the type of cancer, with a significantly poorer lung cancer survival in countries where patients were more likely to initially consult a PCP (lung r=-0.57, 95% CI-0.83 to-0.12; ovary: r=-0.13, 95% CI-0.57 to 0.38; breast r=0.14, 95% CI-0.36 to 0.58; bowel: r=0.20, 95% CI-0.31 to 0.62). Conclusions: There were wide variations in the degree of gatekeeping between countries, with no simple binary model as to whether or not a country has a PCP-as-gatekeeper system. While there was case-by-case variation, there was no overall evidence of a link between a higher probability of initial consultation with a PCP and poorer cancer survival.enghttp://creativecommons.org/licenses/by-nc/4.0/Health care systemsPrimary health careCancerDecision makingDiagnosisEuropeBreast NeoplasmsGatekeepingHumansIntestinal NeoplasmsNeoplasmsMaleProbabilityresearch articleAttribution-NonCommercial 4.0 International2827704435127-3410.1080/02813432.2017.12886921502-7724Scandinavian Journal of Primary Health Careopen accessAnálisis de SupervivenciaFemeninoEuropa (Continente)Control de AccesoActitud del Personal de SaludNeoplasias PulmonaresMasculinoHumanosNeoplasiasProbabilidadNeoplasias IntestinalesDerivación y ConsultaEncuestas y CuestionariosNeoplasias de la MamaAtención Primaria de SaludMédicos de Atención PrimariaNeoplasias Ováricas2-s2.0-85014571071396039600005L618115696