More people are surviving cancer. Early detection of recurrence is important, as it may improve the patient’s prognosis and quality of life. According to the most recent national Cancer Plan by the Danish government, general practice is expected to assume a greater role in future cancer follow-up, yet the existing model remains centred on the hospital setting.

The regular contact between general practitioner (GP) and patient offers good opportunities for detecting early signs of cancer recurrence. However, we know little about the processes preceding a diagnosis of recurrence across multiple cancer types in general practice. 

A new PhD dissertation has examined the extent to which GPs are involved in diagnosing cancer recurrence, how they assess and treat recurrence-related symptoms, and how their actions are associated with patient mortality.

Cancer suspicion triggers referral

The overall project comprises three observational studies, which combine data from a questionnaire survey in general practice with data from national health registries. The studies include patients with recurrence of one of seven investigated cancer types diagnosed between 1 January 2022 and 31 May 2024. 

Four in ten patients had the first diagnostic consultation (index consultation) in general practice. In half of them, the GP suspected cancer, and six in ten were referred for diagnostic work-up. The shortest diagnostic intervals were seen in asymptomatic patients in whom the GP suspected cancer at the index consultation and referred to a fast-track cancer pathway.

Patients who had an index consultation with their GP between scheduled follow-up hospital visits had a twofold increase in two-year mortality risk compared with patients with no GP involved in the index consultation.

GP role should be supported

The results emphasise that the GP plays a crucial role in detecting cancer recurrence. However,  this role could be further supported by structural measures, e.g. improved utilisation of fast-track cancer patient pathways, optimisation of access to hospital specialists, and clear guidelines for GPs.

The studies indicate a high mortality rate among patients having an index consultation in general practice. This is likely related to the advanced stage of disease at diagnosis rather than the actions taken by GPs, which should be considered in future interventions aimed at improving the prognosis of cancer survivors with recurrence.

Defence on 3 March 2026

Kasper Grooss will defend his PhD dissertation entitled ”Cancer recurrence detection in general practice” on Tuesday, 3 March 2026 at 14:00 in the AIAS Auditorium (1663-201), Aarhus University, Høegh-Guldbergs Gade 6B, 8000 Aarhus C.

The oral defence is open to the public. Everyone is welcome. After the defence, the Research Unit for General Practice will host a small reception at the Department of Public Health (1261-118), Aarhus University.

About the project

The PhD dissertation and the three included scientific papers present the results of a three-year enrolment at the Graduate School of Health, Aarhus University. The work was conducted at the Research Unit for General Practice in collaboration with the Department of Public Health, Aarhus University.

The work was supported by grants from the Danish Health Foundation, the Research Foundation for General Practice in the Central Denmark Region, the Danish Foundation for General Practice, the Committee of Multi-practice Studies in General Practice under the Danish College of General Practitioners, the Committee of Quality and Continuing Education in the Central Denmark Region, Lilly and Herbert Hansen’s Foundation and the Department of Public Health at Aarhus University.

Further information

PhD student Kasper Gross 
Aarhus University, Department of Public Health & 
Research Unit for General Practice
Email: k.grooss@ph.au.dk