The results of a study conducted by scientists from the University of Pennsylvania (US), published in the journal JAMA Network Open.
The researchers analyzed data from 2014 to 2016 of 33 primary health care practices in the states of Pennsylvania and New Jersey. In total, about 19 thousand patients of these doctors were screened for breast cancer, according to current guidelines, and about 33 thousand patients were screened for colorectal cancer (malignant neoplasms in the colon and rectum). Scientists kept track of whether these people were examined within one year of the visit to the doctor.
It turned out that this partly depended on the time of day when the patients visited their treating physician – doctors more often suggested referral for an examination during the morning reception than during the evening one. Thus, in the case of breast cancer screening, the probability of the patient being sent for examination at the reception at eight o'clock in the morning & 64% and at the reception at five o'clock & # 39; evening – 48%. As a result, 33% of the morning patients underwent screening, including mammography, and only 18% of the evening patients. For colorectal cancer, the chance of being referred for screening after eight hours of admission was 37%, and at five hours of admission – 23%. During the year, 28% of the morning patients underwent the necessary examinations, including colonoscopy and stool analysis for occult blood, and only 18% of the evening patients.
The authors of the study suggest that this effect can be associated with the accumulating fatigue of doctors, who are already exhausted at the end of the day from the need to constantly make important decisions. This hypothesis is indirectly confirmed by a small increase in the number of screening patients around noon. This may be due to the fact that doctors usually have lunch at the moment, which means they have time to pause and keep their patients head on, the researchers believe.