A health science research year report from Aarhus University shows a markedly increased diagnostic activity for up to two years before the diagnosis of a brain tumor. It suggests that the diagnosis can be made earlier.

2017.04.10 | Lone Niedziella

Medical student Charlotte Nygaard has over the last year studied the clinical activity in health care in the two years prior a diagnosis of a primary brain tumor (Photo: Lars Kruse, AU Photo).

A new study by the Research Centre for Cancer Diagnosis in Primary Care (CaP) at Aarhus University has studied the pre-diagnostic activity in healthcare before the diagnosis of a primary brain tumor.

The results show that there is a '' diagnostic window '' that can be used to ensure earlier diagnosis. This especially applies to patients with benign tumors.

Limited knowledge about the use of healthcare before diagnosis
Brain tumors are difficult to diagnose. The symptoms are often vague or completely "normal" symptoms, occurring in all people. Therefore, it may be difficult for the practitioner and other specialists to distinguish signs of serious illness (e.g. cancer) and a benign condition.

The results of the new study show that there generally is a significantly greater clinical activity in both the primary (general practice) and secondary sector (hospitals) prior to a brain tumor diagnosis. The increased number of contacts can be seen as a sign that the symptoms of possible disease cause the patient to seek medical advice.

A difference between benign and malignant tumors
The study also shows that patients with a benign brain tumor have had increased use of healthcare from up to 2 years before diagnosis. By contrast, the use of healthcare for patients with a malignant tumor increased relatively few months (from 4 months.) prior to the diagnosis.

This therefore suggests that the time from first symptom to diagnosis is relatively short for patients with a malignant brain tumor, while it is generally longer for patients with a benign brain tumor, since many of them have turned to the doctor because of symptoms up to two years before the diagnosis.

A diagnostic window is ajar
General practitioners and other specialists seem to respond to inquiries from patients with signs and symptoms of disease. It can mean that a so-called "diagnostic window" is ajar which allows earlier diagnosis of particularly benign brain tumors.

"Our studies suggest that there is a period prior to the diagnosis, where the symptoms of the tumor gradually becomes so obvious that the doctor will be able to recognize them as signs of disease - and herein lies a significant potential for early diagnosis of the disease" says medical student Charlotte Nygaard, who is behind the study.

Defense at Aarhus University the 25^th of april 2017
Charlotte Nygaard is defending her research year report with the title ‘’Healthcare use before a diagnosis of primary intracranial tumor: a Danish nationwide register study’’ the 25^th of April at 09.00 AM in room 118 (frokoststuen), Building 1261, Department of Public Health, Bartolins Allé 4 at Aarhus University. After the defense there will be reception. The defense is public and everyone interested can attend.

The report emanates from the Graduate School of Health at Aarhus University. Professor Peter Vedsted has been the main supervisor and postdoctoral Henry Jensen has been co-supervisor. The research is conducted in close cooperation between the Research Centre for Cancer Diagnosis in Primary Care (CaP) and the Research Unit for General Practice in Aarhus. The project has received support from the Lundbeck Foundation and the Cancer Society through CaP.

Behind the study

• The purpose was to investigate the use of the Danish healthcare system among adults two years before a brain tumor diagnosis.
• The study is a population-based 1: 10-matched cohort study based on Danish register data for all patients (30-90 years) diagnosed with a brain tumor in the period 1^th January 2009 - 31^th December 2014.
• These health services are part of the study: consultations in general practice, physiotherapy, ear-nose-throat specialist, ophthalmologist, neurologist and psychiatrist and radiological examinations.

Facts about brain tumors

• Each year there is found about 1,500 new cases of primary brain tumors in Denmark.
• A primary brain tumor occurs either in the brain tissue or in the tissue surrounding the brain, while a secondary brain tumor (metastasis) occurs if, for example, a lung cancer spreads to the brain.
• Primary brain tumors are divided into benign and malignant, depending on the tissue type from which the tumor emanates from and the degree of malignancy of the tumor cells. A benign tumor can also cause severe and debilitating symptoms or develop into a malignant tumor over time.
• The cause of a brain tumor is in most cases unknown, but the risk of getting a brain tumor increases with age. Hormones, X-rays and hereditary factors may have an impact.
• A brain tumor can cause various symptoms depending on where it sits and which parts of the brain the tumor presses on.

(Source: www.cancer.dk/hjernetumorer-hjernesvulst)

Contact

Research year student, stud.med. Charlotte Nygaard
Aarhus University, Research Centre for Cancer Diagnosis in Primary Care & The Research Unit for General Practice in Phone: 42428145
charlotte.nygaard@ph.au.dk