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If the doctor opposes her choice, referral to another physician may be the wisest course.
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The questionnaire also requested information about the choice of referral for further investigation for cancer, i.e. whether or not a referral was made to a CPP.
In addition, we aimed to analyse if the GP's suspicion of cancer could predict the choice of referral to a CPP.
CHWs received 5 days of didactic instruction on determining method eligibility (screening), counseling and informed choice, client referral, and provision of oral contraceptive pills, condoms, and DMPA.
This enabled us to classify the GP's choice of referral into the following four distinct categories: Cancer Patient Pathway (CPP), cancer obs.
This indicates that the GP-assessed severity of symptoms influences the diagnostic interval more than the GP's choice of referral mode.
Finally, we aimed to analyse associations between not only cancer suspicion and time to cancer diagnosis, but also between choice of referral route and time to cancer diagnosis.
Given that the majority of the population is registered with and attends their doctor at least once annually, general practice is well positioned to influence patient choice and referral to treatment options and other community services.
We consider this to be non-differential as this is suspected to be the case for all subgroups and hence will not depend on the GPs symptom interpretation and choice of referral route.
Furthermore, as the categorisation of patients according to CPP or not was based on the GPs choice of referral, comparison with all patients diagnosed at hospitals using CPPs must be cautioned.
The GP's choice of referral route was a strong predictor of the duration of the diagnostic interval, but the GP's symptom interpretation was approximately twice as strong an indicator of a longer diagnostic interval.
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CEO of Professional Science Editing for Scientists @ prosciediting.com