Delay Between the Initial Symptoms, the Diagnosis and the Onset of Specific Treatment in Elderly Patients With Lung Cancer

Leprieur, Étienne Giroux; Labrune, Sylvie; Giraud, Violaine; Gendry, Thierry; Cobarzan, Daniel; Chinet, Thierry

doi:10.1016/j.cllc.2011.11.010

Cited by 38 publications

(17 citation statements)

References 30 publications

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“…Prior evidence is inconsistent regarding the presence and direction of associations between age and patient interval for different cancers . We are unaware of previous descriptions of variation in patient interval by housebound status.…”

Section: Discussionmentioning

confidence: 82%

Variation in promptness of presentation among 10,297 patients subsequently diagnosed with one of 18 cancers: Evidence from a National Audit of Cancer Diagnosis in Primary Care

Keeble

Abel

Saunders

et al. 2014

Intl Journal of Cancer

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Cancer awareness public campaigns aim to shorten the interval between symptom onset and presentation to a doctor (the ‘patient interval’). Appreciating variation in promptness of presentation can help to better target awareness campaigns. We explored variation in patient intervals recorded in consultations with general practitioners among 10,297 English patients subsequently diagnosed with one of 18 cancers (bladder, brain, breast, colorectal, endometrial, leukaemia, lung, lymphoma, melanoma, multiple myeloma, oesophageal, oro-pharyngeal, ovarian, pancreatic, prostate, renal, stomach, and unknown primary) using data from of the National Audit of Cancer Diagnosis in Primary Care (2009–2010). Proportions of patients with ‘prompt’/‘non-prompt’ presentation (0–14 or 15+ days from symptom onset, respectively) were described and respective odds ratios were calculated by multivariable logistic regression. The overall median recorded patient interval was 10 days (IQR 0–38). Of all patients, 56% presented promptly. Prompt presentation was more frequent among older or housebound patients (p < 0.001). Prompt presentation was most frequent for bladder and renal cancer (74% and 70%, respectively); and least frequent for oro-pharyngeal and oesophageal cancer (34% and 39%, respectively, p <.001). Using lung cancer as reference, the adjusted odds ratios of non-prompt presentation were 2.26 (95% confidence interval 1.57–3.25) and 0.42 (0.34–0.52) for oro-pharyngeal and bladder cancer, respectively. Sensitivity analyses produced similar findings. Routinely recorded patient interval data reveal considerable variation in the promptness of presentation. These findings can help to prioritise public awareness initiatives and research focusing on symptoms of cancers associated with greater risk of non-prompt presentation, such as oro-pharyngeal and oesophageal cancer.What's new?A critical aspect of cancer diagnosis is how promptly patients consult a doctor after they first notice initial symptoms. Here, the authors examine differences in this so-called patient interval in English patients subsequently diagnosed with one of 18 cancers. On average, patients with bladder and renal cancer as well as older and housebound patients consulted a doctor relatively promptly while patients with oro-pharyngeal and oesophageal cancer took the longest until first presenting to a general practitioner. The authors point out that cancer awareness campaigns should encompass symptoms of oro-pharyngeal and oesophageal cancer aiming to shorten the patient interval for these cancers.

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Section: Discussionmentioning

confidence: 82%

Variation in promptness of presentation among 10,297 patients subsequently diagnosed with one of 18 cancers: Evidence from a National Audit of Cancer Diagnosis in Primary Care

Keeble

Abel

Saunders

et al. 2014

Intl Journal of Cancer

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“…Additionally, the mean time between diagnosis and treatment onset was 43 days. A paper focusing on that endpoint showed that generally the time between the first visit with a thoracic oncologist and treatment onset was around 30 days [28]. Taken together, these data suggest that treatment initiation is shifted at around 1.5 months in prisoners.…”

Section: Discussionmentioning

confidence: 58%

Earlier Onset and Poor Prognosis of Lung Cancer in Imprisoned Patients

Carbonnaux

Fossard

Amzallag³

et al. 2013

Oncology

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Introduction: Prison inmates are known to be more exposed to various lung cancer risk factors, and some studies have shown that lung cancer is the most common cancer in prisoners. However, no study has particularly focused on lung cancer features in this population. Method: Charts of patients with lung cancer hospitalized in one of the French secured hospital units between 1997 and 2012 were reviewed. Data from this cohort were then compared to those of two large observational studies conducted in 2000 and 2010 (KBP studies). Results: Thirty-two cases were included. All were men. The mean age was 52.2 ± 11.5 years, which was significantly lower than in the KBP-2000 (64.4 years) and KBP-2010 (65.5 years; both p < 0.0001) studies. The percentage of current smokers was much higher in prisoners (87.1 vs. 52.2 and 49.2%, respectively; both p < 0.001). Ninety percent of prisoners presented with at least one comorbidity. Lung cancer clinical presentation did not differ between prisoners and the reference populations. The median overall survival was 5.8 months (range 0-15.1) for all stages and 4.7 months (range 2.8-6.6) for stage IIIB/IV. Conclusion: Although our study suffers from limitations, prisoners seem to develop lung cancer at a younger age and their prognosis is poor.

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“…A recent study explored delay in elderly individuals with lung cancer between the initial symptoms, diagnosis, and onset of specific treatment (Leprieur et al, 2012). While Lovgren et al (2008) found longer delays in the elderly individuals in their study, Leprieur et al (2012) found elderly lung cancer patients delayed a similar time span as younger lung cancer patients (median 1.6 months).…”

Section: Delay In Lung Cancermentioning

confidence: 57%

“…While Lovgren et al (2008) found longer delays in the elderly individuals in their study, Leprieur et al (2012) found elderly lung cancer patients delayed a similar time span as younger lung cancer patients (median 1.6 months). In addition, there were no identified differences in the initial symptoms More recent studies have supported the notion that attributing lung cancer symptoms to other conditions (Tod et al, 2008) as well as poor knowledge of lung cancer symptoms (Tod & Joanne, 2010) are key in delayed help-seeking behavior regardless of demographic factors.…”

Section: Delay In Lung Cancermentioning

confidence: 73%

“…of the clinical and surgical management impact (Burmeister et al, 2010;Christensen, Harvald, Jendresen, Aggresrup, & Petterson, 1997;Jensen, Mainz, & Overgaard, 2002;Koyi et al, 2002;Salomaa, Sallinen, Hiekkanen, & Liippo, 2005); one study discusses common signs and symptoms associated with the initial evaluation of lung cancer patients (Spiro, Group, & Colice, 2007); and, one study examines the characteristics of missed opportunities in the lung cancer diagnosis (Singh et al, 2010). The relevant literature that attempts to explain patient delayed help-seeking behavior in lung cancer is isolated to five studies detailed in six published articles (Corner et al, 2005;Corner et al, 2006;Leprieur et al, 2012;Lovgren et al, 2008;Tod et al, 2008;Tod & Joanne, 2010 whether symptom history and pathway toward the diagnosis differed for early stage lung cancer compared to those individuals initially diagnosed at advanced stages. While the first change of health status was generally characterized by one or two symptoms, the number of symptoms at diagnosis was markedly higher (Corner et al, 2005).…”

Section: Delay In Lung Cancermentioning

confidence: 99%

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Influential variables on the timing of help-seeking behavior in lung cancer patients.

Carter‐Harris¹

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Delay Between the Initial Symptoms, the Diagnosis and the Onset of Specific Treatment in Elderly Patients With Lung Cancer

Cited by 38 publications

References 30 publications

Variation in promptness of presentation among 10,297 patients subsequently diagnosed with one of 18 cancers: Evidence from a National Audit of Cancer Diagnosis in Primary Care

Variation in promptness of presentation among 10,297 patients subsequently diagnosed with one of 18 cancers: Evidence from a National Audit of Cancer Diagnosis in Primary Care

Earlier Onset and Poor Prognosis of Lung Cancer in Imprisoned Patients

Influential variables on the timing of help-seeking behavior in lung cancer patients.

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