Senior onderzoeker Zorgdata en het Lerend Zorgsysteem en Eerstelijnszorg/Projectleider LeVEL
Publicatie
Publicatie datum
The prediagnostic general practitioners' pathway of gastrointestinal stromal tumor patients: a real-world data study.
Holthuis, E.I., Slijkhuis, V., Graaf, W.T.A. van der, Drabbe, C., Houdt, W.J. van, Schrage, Y.M., Olde Hartman, T.C., Uijen, A., Steeghs, N., Bos, I., Heins, M., Husson, O. The prediagnostic general practitioners' pathway of gastrointestinal stromal tumor patients: a real-world data study. Cancers: 2025, 17(9), Art. 1391.
Simple Summary
Gastrointestinal stromal tumors (GISTs) are rare digestive tract cancers
that are often challenging to diagnose early due to nonspecific symptoms. General practitioners (GPs) are typically the first to evaluate these symptoms, making them crucial for early detection. However, limited research has examined how GIST patients seek medical care before diagnosis. This study investigates GP visits, reported diagnoses, and prescribed medications in the year preceding a GIST diagnosis. Our findings indicate that GIST patients attend more frequent GP visits, with a significant increase in the months leading up to diagnosis, often due to digestive issues and anemia. Future research should analyze GP records in greater detail to refine strategies for earlier recognition and intervention, eventually leading to faster diagnosis and better patient outcomes.
Abstract
Background/Objectives
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal (GI) tract, predominantly driven by KIT or PDGFRα oncogene mutations. Nonspecific symptoms contribute to diagnostic delays, with general practitioners (GPs) playing a pivotal role in early detection. However, studies on GISTspecific primary care pathways are limited. This study examines GP contacts, diagnoses, and prescribed drugs in primary care during the 12 months preceding GIST diagnosis.
Methods
This case-control study utilized data from the Netherlands Cancer Registry and Nivel Primary Care Database. It included 294 GIST patients diagnosed between 2010 and 2020 and 576 matched cancer-free controls. GP contacts, diagnoses, and newly prescribed drugs were analyzed across two time intervals: 0–4 and 5–12 months prediagnosis. Statistical comparisons were conducted using the Wilcoxon rank-sum test and descriptive analyses.
Results
GIST cases had a median of six GP contacts (IQR 4–11) in the 12 months Cancers 2025, 17, 1391 https://doi.org/10.3390/cancers17091391 Cancers 2025, 17, 1391 2 of 13 prediagnosis versus three (IQR 2–6) for controls (p < 0.05). Contacts increased 4 months before diagnosis, peaking 1 month prior. Common diagnoses in the 4-month interval included malignant neoplasms of the stomach (27.9%) and other digestive sites (27.6% and 11.2%), abdominal pain (9.5%), and iron deficiency anemia (9.5%). Newly prescribed drugs included proton pump inhibitors (13.9%) and osmotically acting laxatives (15.0%). Conclusions: This study highlights increased GP visits and specific reasons for these visits before GIST diagnosis. Future research should further examine GP records, not only through coded data but also unstructured data, and incorporate patient and GP perspectives to explore potential improvements in the diagnostic process.
Gastrointestinal stromal tumors (GISTs) are rare digestive tract cancers
that are often challenging to diagnose early due to nonspecific symptoms. General practitioners (GPs) are typically the first to evaluate these symptoms, making them crucial for early detection. However, limited research has examined how GIST patients seek medical care before diagnosis. This study investigates GP visits, reported diagnoses, and prescribed medications in the year preceding a GIST diagnosis. Our findings indicate that GIST patients attend more frequent GP visits, with a significant increase in the months leading up to diagnosis, often due to digestive issues and anemia. Future research should analyze GP records in greater detail to refine strategies for earlier recognition and intervention, eventually leading to faster diagnosis and better patient outcomes.
Abstract
Background/Objectives
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal (GI) tract, predominantly driven by KIT or PDGFRα oncogene mutations. Nonspecific symptoms contribute to diagnostic delays, with general practitioners (GPs) playing a pivotal role in early detection. However, studies on GISTspecific primary care pathways are limited. This study examines GP contacts, diagnoses, and prescribed drugs in primary care during the 12 months preceding GIST diagnosis.
Methods
This case-control study utilized data from the Netherlands Cancer Registry and Nivel Primary Care Database. It included 294 GIST patients diagnosed between 2010 and 2020 and 576 matched cancer-free controls. GP contacts, diagnoses, and newly prescribed drugs were analyzed across two time intervals: 0–4 and 5–12 months prediagnosis. Statistical comparisons were conducted using the Wilcoxon rank-sum test and descriptive analyses.
Results
GIST cases had a median of six GP contacts (IQR 4–11) in the 12 months Cancers 2025, 17, 1391 https://doi.org/10.3390/cancers17091391 Cancers 2025, 17, 1391 2 of 13 prediagnosis versus three (IQR 2–6) for controls (p < 0.05). Contacts increased 4 months before diagnosis, peaking 1 month prior. Common diagnoses in the 4-month interval included malignant neoplasms of the stomach (27.9%) and other digestive sites (27.6% and 11.2%), abdominal pain (9.5%), and iron deficiency anemia (9.5%). Newly prescribed drugs included proton pump inhibitors (13.9%) and osmotically acting laxatives (15.0%). Conclusions: This study highlights increased GP visits and specific reasons for these visits before GIST diagnosis. Future research should further examine GP records, not only through coded data but also unstructured data, and incorporate patient and GP perspectives to explore potential improvements in the diagnostic process.
Simple Summary
Gastrointestinal stromal tumors (GISTs) are rare digestive tract cancers
that are often challenging to diagnose early due to nonspecific symptoms. General practitioners (GPs) are typically the first to evaluate these symptoms, making them crucial for early detection. However, limited research has examined how GIST patients seek medical care before diagnosis. This study investigates GP visits, reported diagnoses, and prescribed medications in the year preceding a GIST diagnosis. Our findings indicate that GIST patients attend more frequent GP visits, with a significant increase in the months leading up to diagnosis, often due to digestive issues and anemia. Future research should analyze GP records in greater detail to refine strategies for earlier recognition and intervention, eventually leading to faster diagnosis and better patient outcomes.
Abstract
Background/Objectives
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal (GI) tract, predominantly driven by KIT or PDGFRα oncogene mutations. Nonspecific symptoms contribute to diagnostic delays, with general practitioners (GPs) playing a pivotal role in early detection. However, studies on GISTspecific primary care pathways are limited. This study examines GP contacts, diagnoses, and prescribed drugs in primary care during the 12 months preceding GIST diagnosis.
Methods
This case-control study utilized data from the Netherlands Cancer Registry and Nivel Primary Care Database. It included 294 GIST patients diagnosed between 2010 and 2020 and 576 matched cancer-free controls. GP contacts, diagnoses, and newly prescribed drugs were analyzed across two time intervals: 0–4 and 5–12 months prediagnosis. Statistical comparisons were conducted using the Wilcoxon rank-sum test and descriptive analyses.
Results
GIST cases had a median of six GP contacts (IQR 4–11) in the 12 months Cancers 2025, 17, 1391 https://doi.org/10.3390/cancers17091391 Cancers 2025, 17, 1391 2 of 13 prediagnosis versus three (IQR 2–6) for controls (p < 0.05). Contacts increased 4 months before diagnosis, peaking 1 month prior. Common diagnoses in the 4-month interval included malignant neoplasms of the stomach (27.9%) and other digestive sites (27.6% and 11.2%), abdominal pain (9.5%), and iron deficiency anemia (9.5%). Newly prescribed drugs included proton pump inhibitors (13.9%) and osmotically acting laxatives (15.0%). Conclusions: This study highlights increased GP visits and specific reasons for these visits before GIST diagnosis. Future research should further examine GP records, not only through coded data but also unstructured data, and incorporate patient and GP perspectives to explore potential improvements in the diagnostic process.
Gastrointestinal stromal tumors (GISTs) are rare digestive tract cancers
that are often challenging to diagnose early due to nonspecific symptoms. General practitioners (GPs) are typically the first to evaluate these symptoms, making them crucial for early detection. However, limited research has examined how GIST patients seek medical care before diagnosis. This study investigates GP visits, reported diagnoses, and prescribed medications in the year preceding a GIST diagnosis. Our findings indicate that GIST patients attend more frequent GP visits, with a significant increase in the months leading up to diagnosis, often due to digestive issues and anemia. Future research should analyze GP records in greater detail to refine strategies for earlier recognition and intervention, eventually leading to faster diagnosis and better patient outcomes.
Abstract
Background/Objectives
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal (GI) tract, predominantly driven by KIT or PDGFRα oncogene mutations. Nonspecific symptoms contribute to diagnostic delays, with general practitioners (GPs) playing a pivotal role in early detection. However, studies on GISTspecific primary care pathways are limited. This study examines GP contacts, diagnoses, and prescribed drugs in primary care during the 12 months preceding GIST diagnosis.
Methods
This case-control study utilized data from the Netherlands Cancer Registry and Nivel Primary Care Database. It included 294 GIST patients diagnosed between 2010 and 2020 and 576 matched cancer-free controls. GP contacts, diagnoses, and newly prescribed drugs were analyzed across two time intervals: 0–4 and 5–12 months prediagnosis. Statistical comparisons were conducted using the Wilcoxon rank-sum test and descriptive analyses.
Results
GIST cases had a median of six GP contacts (IQR 4–11) in the 12 months Cancers 2025, 17, 1391 https://doi.org/10.3390/cancers17091391 Cancers 2025, 17, 1391 2 of 13 prediagnosis versus three (IQR 2–6) for controls (p < 0.05). Contacts increased 4 months before diagnosis, peaking 1 month prior. Common diagnoses in the 4-month interval included malignant neoplasms of the stomach (27.9%) and other digestive sites (27.6% and 11.2%), abdominal pain (9.5%), and iron deficiency anemia (9.5%). Newly prescribed drugs included proton pump inhibitors (13.9%) and osmotically acting laxatives (15.0%). Conclusions: This study highlights increased GP visits and specific reasons for these visits before GIST diagnosis. Future research should further examine GP records, not only through coded data but also unstructured data, and incorporate patient and GP perspectives to explore potential improvements in the diagnostic process.
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