(P 140) THE PRE-DIAGNOSTIC GENERAL PRACTIONER JOURNEY OF SARCOMA PATIENTS: A REAL-WORLD DATA STUDY.

Objective: The majority of cancer patients are diagnosed after experiencing symptoms specific to their cancer type. However, the frequency and the combination of presenting symptoms, also known as the ‘symptom signature’, vary among different cancer types. Due to the atypical presentation of sarcomas and limited experience among healthcare professionals, the diagnostic interval and referral to specialized sarcoma teams can be prolonged and inappropriate treatment might be initiated. Studying the healthcare utilization, e.g. the frequency of consultations and the presence/type of symptoms at the general practitioner (GP), could offer valuable insights into the symptom signature of sarcomas. The NCR-PCD cohort provides a unique platform to investigate the pre-diagnostic trajectory of sarcoma patients within the primary care setting. The available literature on this subject is, to our best knowledge, limited.

Methods: For this study, data from the Netherlands Cancer Registry (NCR) and the Nivel Primary Care Database (PCD) were linked (the NCR-PCD cohort). All adult (≥18 years of age) sarcoma patients diagnosed between 1 January 2010 and 31 December 2020 were identified from the NCR and included in this study. Baseline characteristics were described as mean ± standard deviation (SD) for continuous variables and as frequencies and percentages for categorical variables.

Results: A total of 782 soft tissue sarcoma (STS), 150 bone sarcoma (BS) and 298 gastrointestinal stromal tumor (GIST) patients were identified from the NCR-PCD cohort between 2010 and 2020. The baseline characteristics of the NCR-PCD cohort are presented in Table 1. The mean age at diagnosis (± SD) across the three groups (STS, BS, GIST) was 62.7 ± 16.3 years, 51.1 ± 16.8 years, 66.7 ± 12.9 years, correspondingly. Mean number of GP consultations within the 12-month period preceding diagnosis was as follows: 9.0 ± 7.0 visits for STS patients, 7.6 ± 6.2 consultations for BS patients, 10.5 ± 7.4 consultations for GIST patients. Table 2 displays the top 10 reasons for GP consultation 12-months prior to sarcoma diagnosis. Uncomplicated hypertension, cystitis/other urinary infection and diabetes mellitus are, among others, surprising nonspecific symptoms for which patients consult the GP. All of these symptoms were most frequently seen among STS patients. While other symptoms including neoplasm musculoskeletal and malignant neoplasm stomach are more specific symptoms that align with the respective diagnosis.

Conclusion: Patients with BS and GIST seem to exhibit symptom presentations that align with their respective diagnoses. Conversely, patients with STS seem to present mostly with nonspecific symptoms. Our future research will focus on creating symptom signatures, specific to the various subtypes of sarcoma, observed in the primary care setting. This could, in the future, potentially improve diagnostics and referral practices for these rare cancers.