Table of Contents
International Journal of Family Medicine
Volume 2015 (2015), Article ID 176812, 12 pages
http://dx.doi.org/10.1155/2015/176812
Research Article

Does the Primary Care Experience Influence the Cancer Diagnostic Process?

1Direction de Santé Publique, Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Sud-de-l’Île-de-Montréal, 1301 rue Sherbrooke Est, Montréal, QC, Canada H2L 1M3
2Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Hôtel-Dieu, Pavillon Masson, 3480 rue Saint-Urbain, Montréal, QC, Canada H4W 1Y1
3Institut de Recherche en Santé Publique de l’Université de Montréal, 7101 avenue du Parc, Montréal, QC, Canada H3N 1X9
4Institut National de Santé Publique du Québec, 945 avenue Wolfe, Québec, QC, Canada G1V 5B3
5Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 avenue des Pins Ouest, Montréal, QC, Canada H3A 1A2
6Centre de Recherche de l’Hôpital Charles-LeMoyne, Université de Sherbrooke, Campus de Longueuil, 150 place Charles-LeMoyne, Longueuil, QC, Canada J4K 0A8
7Département des Sciences de la Santé Communautaire, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Pavillon Gérald-Lasalle, 3001 12e avenue, Sherbrooke, QC, Canada J1H 5H3
8École des Sciences Infirmières, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Pavillon Gérald-Lasalle, 3001 12e avenue, Sherbrooke, QC, Canada J1H 5H3

Received 8 July 2015; Revised 3 September 2015; Accepted 7 September 2015

Academic Editor: Samuel Y. S. Wong

Copyright © 2015 Sylvie Provost et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To analyze the impact of patients’ experience of care at their usual source of primary care on their choice of point of entry into cancer investigation process, time to diagnosis, and presence of metastatic cancer at time of diagnosis. Method. A questionnaire was administered to 438 patients with cancer (breast, lung, and colorectal) between 2011 and 2013 in four oncology clinics of Quebec (Canada). Multiple regression analyses (logistic and Cox models) were conducted. Results. Among patients with symptoms leading to investigation of cancer (), 47% used their usual source of primary care as the point of entry for investigation. Greater comprehensiveness of care was associated with the decision to use this source as point of entry (OR = 1.25; CI 90% = 1.06–1.46), as well as with shorter times between first symptoms and investigation (HR = 1.11; ), while greater accessibility was associated with shorter times between investigation and diagnosis (HR = 1.13; ).  Conclusion. Experience of care at the usual source of primary care has a slight influence on the choice of point of entry for cancer investigation and on time to diagnosis. This influence appears to be more related to patients’ perceptions of the accessibility and comprehensiveness of their usual source of primary care.