Healthcare use in the year preceding a diagnosis of pancreatic cancer: a register-based cohort study in Denmark

Abstract

Objective

To describe the use of healthcare prior to a diagnosis of pancreatic cancer in Denmark.

Design

A population-based cohort study using prospectively recorded data from Danish National Health Registries.

Setting

Danish general practice and hospitals.

Subjects

A total of 5926 patients diagnosed with pancreatic cancer in 2012–2018 and 59,260 matched references without pancreatic cancer from the Danish general population.

Main outcome measures

The monthly frequency of healthcare use (contacts and tests in general practice and contacts and diagnostic investigations in hospitals) during the 12 months preceding the pancreatic cancer diagnosis and a corresponding index date assigned to the references.

Results

Compared to the references, the patients had increased contacts and diagnostic tests, especially blood glucose testing, in general practice from 7 to 12 months before diagnosis. Hospital contacts and diagnostic imaging increased from 5 months before the diagnosis.

Conclusions

The pattern of increasing healthcare contacts before a diagnosis of pancreatic cancer may represent a window of opportunity to diagnose pancreatic cancer earlier. The increased use of blood glucose test in general practice may represent an important sign of an underlying disease.

Key points

• Pancreatic cancer is a rapidly progressing and highly lethal disease. Focus on early diagnosis is essential to improve the prognosis.

• Patients with pancreatic cancer had increased number of healthcare contacts from 7 months before the diagnosis.

• Patients with pancreatic cancer had increased number of blood glucose tests taken throughout almost the entire year before the diagnosis.

• The results may indicate that a window of opportunity exists to diagnose pancreatic cancer earlier.

Keywords:

• Pancreatic neoplasms
• early detection of cancer
• general practice
• health services research
• Denmark

Acknowledgements

The authors wish to thank data manager Kaare Rud Flarup for data retrieval from the national registries, and the Danish Pancreatic Cancer Group for providing the data for the study.

Ethics

The project is part of the PanOvar project, which is recorded in the research register (ID: 182) at the Research Unit for General Practice in Aarhus in accordance with Danish and European Union data protection regulations (GDPR). The Danish Clinical Registries provided permission to receive and use data from the Danish Pancreas Cancer Database. According to Danish law, approval by the regional committee on health research ethics in the Central Denmark Region is not required as no biomedical intervention was performed.

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

The study was supported by the M. L. Jørgensen and Gunner Hansen’s Foundation and the Danish General Practice Fund.