Background/Objectives: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal (GI) tract, predominantly driven by KIT or PDGFRα oncogene mutations. Nonspecific symptoms contribute to diagnostic delays, with general practitioners (GPs) playing a pivotal role in early detection. However, studies on GIST-specific primary care pathways are limited. This study examines GP contacts, diagnoses, and prescribed drugs in primary care during the 12 months preceding GIST diagnosis.Methods: This case-control study utilized data from the Netherlands Cancer Registry and Nivel Primary Care Database. It included 294 GIST patients diagnosed between 2010 and 2020 and 576 matched cancer-free controls. GP contacts, diagnoses, and newly prescribed drugs were analyzed across two time intervals: 0–4 and 5–12 months prediagnosis. Statistical comparisons were conducted using the Wilcoxon rank-sum test and descriptive analyses.Results: GIST cases had a median of six GP contacts (IQR 4–11) in the 12 months prediagnosis versus three (IQR 2–6) for controls (p< 0.05). Contacts increased 4 months before diagnosis, peaking 1 month prior. Common diagnoses in the 4-month interval included malignant neoplasms of the stomach (27.9%) and other digestive sites (27.6% and 11.2%), abdominal pain (9.5%), and iron deficiency anemia (9.5%). Newly prescribed drugs included proton pump inhibitors (13.9%) and osmotically acting laxatives (15.0%).Conclusions: This study highlights increased GP visits and specific reasons for these visits before GIST diagnosis. Future research should further examine GP records, not only through coded data but also unstructured data, and incorporate patient and GP perspectives to explore potential improvements in the diagnostic process.
**背景/目的：** 胃肠道间质瘤是胃肠道罕见的间叶源性肿瘤，主要由KIT或PDGFRα癌基因突变驱动。其症状的非特异性常导致诊断延迟，全科医生在早期发现中起着关键作用。然而，针对GIST特异性初级诊疗路径的研究有限。本研究旨在分析GIST确诊前12个月内，患者在初级医疗保健中的全科医生就诊情况、诊断及处方药物。 **方法：** 本病例对照研究使用了荷兰癌症登记处和Nivel初级医疗数据库的数据。研究纳入了2010年至2020年间确诊的294名GIST患者和576名匹配的无癌对照者。分析在确诊前两个时间段（0-4个月和5-12个月）内的全科医生就诊、诊断和新处方药物情况。采用Wilcoxon秩和检验和描述性分析进行统计学比较。 **结果：** 在确诊前12个月内，GIST病例组的中位全科医生就诊次数为6次（四分位距4-11），而对照组为3次（四分位距2-6）（p < 0.05）。就诊次数在诊断前4个月开始增加，并在诊断前1个月达到峰值。在诊断前4个月内的常见诊断包括：胃恶性肿瘤（27.9%）、其他消化部位恶性肿瘤（27.6%和11.2%）、腹痛（9.5%）和缺铁性贫血（9.5%）。新处方药物包括质子泵抑制剂（13.9%）和渗透性泻药（15.0%）。 **结论：** 本研究揭示了GIST确诊前患者全科医生就诊次数增加及其具体原因。未来的研究应进一步深入分析全科医生记录，不仅限于编码数据，还应纳入非结构化数据，并结合患者和全科医生的视角，以探索诊断过程中潜在的改进之处。
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