Direct-access to abdominal ultrasonic investigation from general practice—the role in earlier cancer diagnosis

Fam Pract. 2015 Apr;32(2):205-10. doi: 10.1093/fampra/cmv004. Epub 2015 Feb 24.


Background: Abdominal ultrasound (US) is a safe and low-cost diagnostic tool for various abdominal symptoms. Direct-access to US from general practice has been suggested as a feasible option to promote earlier cancer diagnosis because abdominal cancer often presents with non-specific and vague symptoms, and the exact location may be difficult to identify on the basis of symptoms alone.

Objective: To describe patterns of use and cancer prevalence in referred patients when providing Danish GPs with direct-access to hospital-based US.

Methods: In an observational study, GPs were given the opportunity to either refer patients directly to US or through a waiting-list at Vejle Regional Hospital in Denmark; 701 patients were included between 1 August 2009 and 31 January 2010. Data were retrieved from the local Radiology Information System, GP referrals and the Danish Cancer Registry.

Results: GPs referred 60% of all patients to direct-access US. Cancer was diagnosed in 19 (2.7%) of the referred patients within 6 months after the US investigation. US gave rise to the suspicion of cancer in 11 of these patients (57.9%); 10 of these had been referred to direct-access US. At least one non-malignant diagnosis resulted from US in 59.5% of the cases, while 37.8% of the cases had no final diagnosis.

Conclusion: The findings in this study might indicate that GPs refer patients assessed to have a higher risk of cancer through direct-access US. The finding was statistically non-significant, and further research is required to confirm this result.

Keywords: Denmark; diagnosis; diagnostic imaging; general practice; neoplasms; ultrasonography..

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / diagnostic imaging*
  • Abdominal Neoplasms / diagnostic imaging*
  • Abdominal Neoplasms / epidemiology*
  • Abdominal Pain / etiology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Denmark / epidemiology
  • Early Detection of Cancer*
  • Female
  • General Practice*
  • Humans
  • Liver Function Tests
  • Male
  • Middle Aged
  • Outpatient Clinics, Hospital*
  • Prevalence
  • Referral and Consultation
  • Ultrasonography
  • Waiting Lists
  • Young Adult