How frequently do young people with potential cancer symptoms present in primary care?

Abstract

BACKGROUND: Although uncommon in teenagers and young adults, cancer is the leading cause of non-accidental death in those aged 15-24 years. A prolonged period to cancer diagnosis in this cohort is reported and thought to be a consequence of the rarity of cancer in this age group, together with the complexity of presenting symptoms. Although diagnostic delay is perceived to be a problem for teenagers and young adults with cancer, little research has focused on their use of primary care services. AIM: To determine how often teenagers and young adults consult, their reasons for doing so, and how often potential oncological symptoms ('alert' symptoms) appear. DESIGN AND SETTING: Retrospective audit of consultations over 1 year. Three general medical practices in Scotland. METHOD: Medical records were examined for 2326 teenagers and young adults. Date of birth, sex, and free-text relating to the consultation were recorded and coded according to an agreed coding system; symptoms of potential oncological significance were coded as alert symptoms. RESULTS: A total of 1659 teenagers and young adults (71.3% of registered patients) attended their GP at least once. Females attended more frequently than males (P < 0.001), and older females more frequently than younger females (P < 0.001). Males exhibited no association between consultation frequency and age. The main reasons for consultation were pregnancy/contraception (15.8%) and infection (15.7%). Alert symptoms were uncommon, (reported in 4.0% of all consultations; 276 alert symptoms in 179 patients), and were not associated with age or sex. The most common alert symptoms were unexplained pain (34.8%), unexplained fatigue (14.5%), and lumps (13.4%). Two benign tumours were detected. CONCLUSION: A high proportion of teenagers and young adults consult their GP. Alert symptoms are uncommon and generally occur in isolation. More research is required to confirm these findings in a larger cohort and to examine how GPs respond to such alert symptoms.