Does the Primary Care Experience Influence the Cancer Diagnostic Process?

Table 6

Factors associated with symptoms-to-investigation and investigation-to-diagnosis times ().

	First symptoms-to-investigation time		Investigation-to-diagnosis time
	Hazard ratio^2	value	Hazard ratio^2	value
Cancer site (ref.: breast)
Lung	1.03	0.868	1.46	0.035
Colorectal	0.94	0.745	1.28	0.179
Symptom urgency (ref.: yes)
No	0.82	0.220	0.92	0.598
Sex (ref.: male)
Female	1.14	0.440	1.06	0.724
Age^1	1.01	0.268	1.00	0.762
Education level (ref.: primary or secondary)
College or university	1.05	0.744	1.03	0.808
Accessibility at the usual source of PHC^1	1.06	0.223	1.13	0.004
Continuity at the usual source of PHC^1	0.95	0.485	1.00	0.997
Comprehensiveness at the usual source of PHC^1	1.11	0.052	1.01	0.828
Correspondence between point of entry into investigation and usual source of PHC (ref.: usual source of PHC = point of entry)
Usual source of PHC ≠ point of entry	0.91	0.542	1.40	0.023
No source of PHC	1.71	0.473	4.00	0.036

In these models, age and experience of care indices are continuous variables.
²For the Cox regression regarding first symptoms-to-investigation time, the origin of the time-scale of the analysis was the date of first symptoms and the exit point was the start of investigation. For the analysis of investigation-to-diagnosis time, the origin of the time-scale of the analysis was the start of the investigation and the exit point was the disclosure of the diagnosis. A hazard ratio greater than one indicates a shorter time, that is, that the event (investigation, for the symptoms-to-investigation time, and diagnosis, for the investigation-to-diagnosis time) occurred more rapidly.
Note: results were similar for models including level of morbidity or type of PHC clinic as covariates, for models excluding symptom urgency, and for analyses performed for the subgroup of patients who had used their usual source of PHC as point of entry into cancer investigation.