Abstract：
BACKGROUND: Cancer is a major public health problem in France. Idiopathic venous thromboembolic disease may be one of the modes of discovery. Few studies have been performed on this subject in primary care. The general practitioner plays a key role in the diagnosis for which a more codified approach seems desirable. The aim was to study how general practitioners conceive the search for cancer in patients with idiopathic venous thromboembolic disease in primary care.
METHODS: A qualitative study, inspired by the grounded theory approach, was carried out using semi-structured interviews with 12 established general practitioners. It was conducted from May to July 2022. The interview guide was developed based on data from the literature.
RESULTS: Idiopathic venous thromboembolic disease as a mode of cancer discovery in primary care was a well-known topic among general practitioners but remained a difficult exercise in practice. Our study revealed similarities in their practices: a complete anamnesis, clinical examination, verification of screening tests, and finally a TAP scan. They emphasized the importance of collaboration with angiologists and asked for a more codified management.
CONCLUSIONS: The question of etiology of cancer remains unanswered. General practioners would like to be made aware of a common, codified attitude. This raises the question of the applicability of the recommendations. The aim is to avoid misdiagnosing a cancer or delaying a diagnosis, while at the same time, not unnecessarily exposing certain patients to excessive investigations when these are not needed. So, it is time to think about better dissemination of recommendations, tools to help GPs easily finding what they need among the multitude of existing recommendations and tools, to establish better collaboration between general practice and hospital medicine, and between general practice and specialist medicine in order to improve cancer diagnosis as early as possible.
METHODS: A qualitative study, inspired by the grounded theory approach, was carried out using semi-structured interviews with 12 established general practitioners. It was conducted from May to July 2022. The interview guide was developed based on data from the literature.
RESULTS: Idiopathic venous thromboembolic disease as a mode of cancer discovery in primary care was a well-known topic among general practitioners but remained a difficult exercise in practice. Our study revealed similarities in their practices: a complete anamnesis, clinical examination, verification of screening tests, and finally a TAP scan. They emphasized the importance of collaboration with angiologists and asked for a more codified management.
CONCLUSIONS: The question of etiology of cancer remains unanswered. General practioners would like to be made aware of a common, codified attitude. This raises the question of the applicability of the recommendations. The aim is to avoid misdiagnosing a cancer or delaying a diagnosis, while at the same time, not unnecessarily exposing certain patients to excessive investigations when these are not needed. So, it is time to think about better dissemination of recommendations, tools to help GPs easily finding what they need among the multitude of existing recommendations and tools, to establish better collaboration between general practice and hospital medicine, and between general practice and specialist medicine in order to improve cancer diagnosis as early as possible.
摘要：
背景：癌症是法国的主要公共卫生问题。特发性静脉血栓栓塞性疾病可能是发现的模式之一。在初级保健中，很少有关于这一主题的研究。全科医生在诊断中起着关键作用，似乎需要采用更规范的方法。目的是研究全科医生如何设想在初级保健中寻找特发性静脉血栓栓塞性疾病患者的癌症。
方法：定性研究，受到扎根理论方法的启发，是通过对12名既定全科医生的半结构化访谈进行的。它于2022年5月至7月进行。采访指南是根据文献中的数据开发的。
结果：特发性静脉血栓栓塞性疾病作为初级保健中癌症发现的一种模式，在全科医生中是一个众所周知的话题，但在实践中仍然是一个困难的练习。我们的研究揭示了他们实践中的相似之处：完整的回忆，临床检查,筛选试验的验证，最后是TAP扫描。他们强调了与血管学家合作的重要性，并要求进行更规范的管理。
结论：癌症的病因学问题仍未得到解答。全科医生希望知道一个常见的，成文的态度。这就提出了建议是否适用的问题。目的是避免误诊癌症或延迟诊断，同时,当不需要这些时，不要不必要地将某些患者暴露于过度的检查。所以,是时候考虑更好地传播建议了，帮助GP在众多现有建议和工具中轻松找到他们需要的工具，为了在全科医学和医院医学之间建立更好的合作，以及全科医学和专科医学之间的联系，以便尽早改善癌症诊断。
方法：定性研究，受到扎根理论方法的启发，是通过对12名既定全科医生的半结构化访谈进行的。它于2022年5月至7月进行。采访指南是根据文献中的数据开发的。
结果：特发性静脉血栓栓塞性疾病作为初级保健中癌症发现的一种模式，在全科医生中是一个众所周知的话题，但在实践中仍然是一个困难的练习。我们的研究揭示了他们实践中的相似之处：完整的回忆，临床检查,筛选试验的验证，最后是TAP扫描。他们强调了与血管学家合作的重要性，并要求进行更规范的管理。
结论：癌症的病因学问题仍未得到解答。全科医生希望知道一个常见的，成文的态度。这就提出了建议是否适用的问题。目的是避免误诊癌症或延迟诊断，同时,当不需要这些时，不要不必要地将某些患者暴露于过度的检查。所以,是时候考虑更好地传播建议了，帮助GP在众多现有建议和工具中轻松找到他们需要的工具，为了在全科医学和医院医学之间建立更好的合作，以及全科医学和专科医学之间的联系，以便尽早改善癌症诊断。
