Advanced‐stage cancer and time to diagnosis: An International Cancer Benchmarking Partnership (ICBP) cross‐sectional study

Tørring, Marie Louise; Falborg, Alina Zalounina; Jensen, Henry; Neal, Richard D; Weller, David; Reguilon, Irene; Menon, Usha; Vedsted, Peter

doi:10.1111/ecc.13100

Cited by 54 publications

(48 citation statements)

References 54 publications

(97 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with advanced tumours generally receive an expedited diagnosis (possibly as an emergency) and have poor outcomes because of their high inherent mortality: the so-called “sick-quick”. Conversely, patients presenting with vague symptoms usually have longer diagnostic intervals, and higher mortality – thought to reflect the impact of diagnostic delay, particularly between referral and diagnosis [ [32] , [33] , [34] , [35] ]. The revised guidance aimed to benefit patients by legitimising doctors to investigate at a lower risk of undiagnosed cancer.…”

Section: Discussionmentioning

confidence: 99%

Trends in time to cancer diagnosis around the period of changing national guidance on referral of symptomatic patients: A serial cross-sectional study using UK electronic healthcare records from 2006–17

Price¹,

Spencer²,

Zhang³

et al. 2020

Cancer Epidemiology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Trends in time to cancer diagnosis around the period of changing national guidance on referral of symptomatic patients: A serial cross-sectional study using UK electronic healthcare records from 2006–17

Price¹,

Spencer²,

Zhang³

et al. 2020

Cancer Epidemiology

View full text Add to dashboard Cite

show abstract

“…21 The third sensitivity analysis involved repeating the main analysis by restricting it to patients who had a diagnostic interval (time from symptomatic presentation to diagnosis) of 0-60 days, since time to diagnosis could influence the association between presenting symptoms and stage. 22 For the fourth sensitivity analysis, we adjusted for route to diagnosis as the association between route to cancer diagnosis (a patient's health-care utilisation pathway before diagnosis) and stage might also influence the association of interest. 23 Therefore, the main analysis was repeated with further adjustment for route to diagnosis among patients with complete information about their diagnostic route.…”

Section: Implications Of All the Available Evidencementioning

confidence: 99%

Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study

Koo

Swann

McPhail

et al. 2020

The Lancet Oncology

163

106

View full text Add to dashboard Cite

Background Early diagnosis interventions such as symptom awareness campaigns increasingly form part of global cancer control strategies. However, these strategies will have little impact in improving cancer outcomes if the targeted symptoms represent advanced stage of disease. Therefore, we aimed to examine associations between common presenting symptoms of cancer and stage at diagnosis. Methods In this cross-sectional study, we analysed population-level data from the English National Cancer Diagnosis Audit 2014 for patients aged 25 years and older with one of 12 types of solid tumours (bladder, breast, colon, endometrial, laryngeal, lung, melanoma, oral or oropharyngeal, ovarian, prostate, rectal, and renal cancer). We considered 20 common presenting symptoms and examined their associations with stage at diagnosis (TNM stage IV vs stage I-III) using logistic regression. For each symptom, we estimated these associations when reported as a single presenting symptom and when reported together with other symptoms. Findings We analysed data for 7997 patients. The proportion of patients diagnosed with stage IV cancer varied substantially by presenting symptom, from 1% (95% CI 1-3; eight of 584 patients) for abnormal mole to 80% (71-87; 84 of 105 patients) for neck lump. Three of the examined symptoms (neck lump, chest pain, and back pain) were consistently associated with increased odds of stage IV cancer, whether reported alone or with other symptoms, whereas the opposite was true for abnormal mole, breast lump, postmenopausal bleeding, and rectal bleeding. For 13 of the 20 symptoms (abnormal mole, breast lump, post-menopausal bleeding, rectal bleeding, lower urinary tract symptoms, haematuria, change in bowel habit, hoarseness, fatigue, abdominal pain, lower abdominal pain, weight loss, and the "any other symptom" category), more than 50% of patients were diagnosed at stages other than stage IV; for 19 of the 20 studied symptoms (all except for neck lump), more than a third of patients were diagnosed at stages other than stage IV. Interpretation Despite specific presenting symptoms being more strongly associated with advanced stage at diagnosis than others, for most symptoms, large proportions of patients are diagnosed at stages other than stage IV. These findings provide support for early diagnosis interventions targeting common cancer symptoms, countering concerns that they might be simply expediting the detection of advanced stage disease.

show abstract

“… 1 There are no effective interventions to support asymptomatic detection through population screening for most of this group, but expediting the diagnosis of individuals with symptoms may help improve clinical and patient-reported outcomes. 2 , 3 , 4 , 5 , 6 , 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

Association of Self-reported Presenting Symptoms With Timeliness of Help-Seeking Among Adolescents and Young Adults With Cancer in the BRIGHTLIGHT Study

et al. 2020

View full text Add to dashboard Cite

Key Points Question What are the common presenting symptoms of cancer in adolescents and young adults aged 12 to 24 years and how are they associated with help-seeking? Findings This cross-sectional analysis of 803 adolescents and young adult patients found a range of presenting symptoms in diverse combinations, which varied by cancer group; 27% of patients waited more than 1 month to seek help for their symptoms. Meaning These findings suggest that adolescents and young adults with cancer present with a broad spectrum of symptoms, often at substantially higher proportions than previously reported; thus, re-examination of symptom prevalence in this patient group is warranted.

show abstract

Advanced‐stage cancer and time to diagnosis: An International Cancer Benchmarking Partnership (ICBP) cross‐sectional study

Cited by 54 publications

References 54 publications

Trends in time to cancer diagnosis around the period of changing national guidance on referral of symptomatic patients: A serial cross-sectional study using UK electronic healthcare records from 2006–17

Trends in time to cancer diagnosis around the period of changing national guidance on referral of symptomatic patients: A serial cross-sectional study using UK electronic healthcare records from 2006–17

Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study

Association of Self-reported Presenting Symptoms With Timeliness of Help-Seeking Among Adolescents and Young Adults With Cancer in the BRIGHTLIGHT Study

Contact Info

Product

Resources

About