چکیده (انگلیسی):

Background:Continuing medical education (CME) in earlier cancer diagnosis was launched in Denmark in 2012 as
part of the Danish National Cancer Plan. The CME programme was introduced to improve the recognition among
general practitioners (GPs) of symptoms suggestive of cancer and improve the selection of patients requiring
urgent investigation. This study aims to explore the effect of CME on GP knowledge about cancer diagnosis,
attitude towards own role in cancer detection, self-assessed readiness to investigate and cancer risk assessment of
urgently referred patients.
Methods:We conducted a before-after study in the Central Denmark Region including 831 GPs assigned to one of
eight geographical clusters. All GPs were invited to participate in the CME at three-week intervals between clusters.
A questionnaire focusing on knowledge, attitude and clinical vignettes was sent to each GP one month before and
seven months after the CME. The GPs were also asked to assess the risk of cancer in patients urgently referred to a
fast-track cancer pathway during an eight-month period. CME-participating GPs were compared with reference
(non-participating) GPs by analysing before-after differences.
Results:One quarter of all GPs participated in the CME. 202 GPs (24.3 %) completed both the baseline and the
follow-up questionnaires. 532 GPs (64.0 %) assessed the risk of cancer before the CME and 524 GPs (63.1 %)
assessed the risk of cancer after the CME in urgently referred consecutive patients. Compared to the reference
group, CME-participating GPs statistically significantly improved their understanding of a rational probability of
diagnosing cancer among patients urgently referred for suspected cancer, increased their knowledge of cancer
likelihood in a 50-year-old referred patient and lowered the assessed risk of cancer in urgently referred patients.
Conclusions:The standardised CME lowered the GP-assessed cancer risk of urgently referred patients, whereas the
effect on knowledge about cancer diagnosis and attitude towards own role in cancer detection was limited. No
effect was found on the GPs’ readiness to investigate. CME may be effective for optimising the interpretation of
cancer symptoms and thereby improve the selection of patients for urgent cancer referral.
Trial registration:NCT02069470 on ClinicalTrials.gov. Retrospectively registered, 1/29/2014.