Abstract

Objective

Relative one-year cancer survival rates in the Baltic states are lower than the European mean; in the Nordic countries they are higher than the mean. This study investigated the likelihood of General Practitioners (GPs) investigating or referring patients with a low but significant risk of cancer in these two regions, and how this was affected by GP demographics.

Design

A survey of GPs using clinical vignettes.

Setting

General Practice in Denmark, Estonia, Finland, Latvia, Lithuania, Norway, and Sweden.

Subjects

General Practitioners.

Outcome measures

A regional comparison of GPs’ stated immediate diagnostic actions (whether or not they would perform a key diagnostic test and/or refer to a specialist) for patients with a low but significant risk of cancer (between 1.2 and 3.6%).

Results

Of the 427 GPs that completed the questionnaire, those in the Baltic states, and GPs that were more experienced, were more likely to arrange a key diagnostic test and/or refer their patient to a specialist than those in Nordic Countries or who were less experienced (p < 0.001 for both measures). Neither GP sex nor practice location within a country showed a significant association with these measures.

Conclusion

While relative one-year cancer survival rates are lower in the Baltic states than in four Nordic countries, we found no evidence that this is due to their GPs’ reluctance to take immediate diagnostic action, as GPs in the Baltic states were more likely to investigate and/or refer at the first consultation. Research on patient and secondary care factors is needed to explain the survival differences.

Details

Title
General practitioners’ clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries
Author
Rosendahl, Alexander 1 ; Vanaveski, Anet 2 ; Pilv-Toom, Liina 1   VIAFID ORCID Logo  ; Blumfelds, Jānis 3   VIAFID ORCID Logo  ; Siliņa, Vija 3   VIAFID ORCID Logo  ; Brekke, Mette 4   VIAFID ORCID Logo  ; Koskela, Tuomas 5   VIAFID ORCID Logo  ; Rapalavičius, Aurimas 6   VIAFID ORCID Logo  ; Thulesius, Hans 7   VIAFID ORCID Logo  ; Vedsted, Peter 8   VIAFID ORCID Logo  ; Harris, Michael 9   VIAFID ORCID Logo 

 Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia 
 Family Medicine Residency, University of Tartu, Tartu, Estonia 
 Department of Family Medicine, Riga Stradiņš University, Riga, Latvia 
 Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway 
 Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Wellbeing Services County of Pirkanmaa, Tampere, Finland 
 Department of Family Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania 
 Department of Family Medicine, Riga Stradiņš University, Riga, Latvia; Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden 
 Research Unit for General Practice, Aarhus, Denmark; Department of Clinical Medicine, University Clinic for Innovative Patient Pathways, Aarhus University, Aarhus, Denmark 
 Department of Family Medicine, Riga Stradiņš University, Riga, Latvia; Department for Health, University of Bath, Bath, UK; Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland 
Pages
403-410
Publication year
2025
Publication date
Jun 2025
Publisher
Taylor & Francis LLC
ISSN
02813432
e-ISSN
15027724
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3206351365
Copyright
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.