Delays experienced by patients with symptomatic colorectal cancer

Wheeler,; Wakefield,; Mortensen, N. J. McC.; Kettlewell,

doi:10.1046/j.1463-1318.1999.00043.x

Cited by 8 publications

(8 citation statements)

References 8 publications

(12 reference statements)

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“…Other studies have also found symptom duration to be longer for rectal cancer than for colon cancer (9,11). In this study the difference disappeared when the emergency group was excluded.…”

Section: Discussioncontrasting

confidence: 38%

“…Overall, patients' delay in reporting their problems was comparatively short (11,12) but they still expressed a tendency to wait before presenting with symptoms. Patients reported lack of knowledge to be the most important reason for not presenting more promptly.…”

Section: Discussionmentioning

confidence: 99%

“…Duration of symptoms varies owing to such factors as knowledge of the significance of bowel symptoms (4,5), psychological reasons (6) and the diagnostic capacity of the health-care system (7,8). A lack of association between symptom duration and stage has been demonstrated in several prospective studies on consecutive series from referral centres (9)(10)(11)(12). This was also shown to be the case for colon cancer in one population-based study (13).…”

mentioning

confidence: 89%

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Symptom duration versus survival in non‐emergency colorectal cancer

Olsson

Bergkvist

Ekbom

2004

Scandinavian Journal of Gastroenterology

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“…Other studies have also found symptom duration to be longer for rectal cancer than for colon cancer (9,11). In this study the difference disappeared when the emergency group was excluded.…”

Section: Discussioncontrasting

confidence: 38%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 89%

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Symptom duration versus survival in non‐emergency colorectal cancer

Olsson

Bergkvist

Ekbom

2004

Scandinavian Journal of Gastroenterology

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“…This may be because when the GP has a clear suspicion, the referral is made more promptly and the response of hospital doctors to this type of referral is faster [44,45]. …”

Section: Discussionmentioning

confidence: 99%

Factors related with symptom duration until diagnosis and treatment of symptomatic colorectal cancer

et al. 2013

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BackgroundColorectal cancer (CRC) survival depends mostly on stage at the time of diagnosis. However, symptom duration at diagnosis or treatment have also been considered as predictors of stage and survival. This study was designed to: 1) establish the distinct time-symptom duration intervals; 2) identify factors associated with symptom duration until diagnosis and treatment.MethodsThis is a cross-sectional study of all incident cases of symptomatic CRC during 2006–2009 (795 incident cases) in 5 Spanish regions. Data were obtained from patients’ interviews and reviews of primary care and hospital clinical records. Measurements: CRC symptoms, symptom perception, trust in the general practitioner (GP), primary care and hospital examinations/visits before diagnosis, type of referral and tumor characteristics at diagnosis. Symptom Diagnosis Interval (SDI) was calculated as time from first CRC symptoms to date of diagnosis. Symptom Treatment Interval (STI) was defined as time from first CRC symptoms until start of treatment. Nonparametric tests were used to compare SDI and STI according to different variables.ResultsSymptom to diagnosis interval for CRC was 128 days and symptom treatment interval was 155. No statistically significant differences were observed between colon and rectum cancers. Women experienced longer intervals than men. Symptom presentation such as vomiting or abdominal pain and the presence of obstruction led to shorter diagnostic or treatment intervals. Time elapsed was also shorter in those patients that perceived their first symptom/s as serious, disclosed it to their acquaintances, contacted emergencies services or had trust in their GPs. Primary care and hospital doctor examinations and investigations appeared to be related to time elapsed to diagnosis or treatment.ConclusionsResults show that gender, symptom perception and help-seeking behaviour are the main patient factors related to interval duration. Health service performance also has a very important role in symptom to diagnosis and treatment interval. If time to diagnosis is to be reduced, interventions and guidelines must be developed to ensure appropriate examination and diagnosis during both primary and hospital care.

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“…An ambitious aim would be to achieve a time lag of up to 4 months before treatment in all patients, allowing 4 weeks from the onset of symptoms to a general practitioner consultation, 2 weeks for general practitioner referral, a 2-week wait for an outpatient appointment, and 6 weeks for diagnosis, staging and treatment. However, average delay can vary between 4 and 9 months [18][19][20][21][22][23][24][25][26][27][28] ( Table 1) and has remained constant for 60 years (Table 2) [18,19,22,23,[29][30][31][32][33][34][35][36][37][38][39][40]. A delay of over 6 months occurs in 30% of patients and of over a year in around 10% ( Table 2).…”

Section: Methods Of Assessing the Evidencementioning

confidence: 99%

Earlier diagnosis and treatment of symptomatic bowel cancer: can it be achieved and how much will it improve survival?

Thompson¹,

Heath²,

Swarbrick³

et al. 2010

Colorectal Disease

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Campaigns to earlier diagnose bowel cancer will not be successful unless new strategies are developed. There is substantial evidence that earlier diagnosis of symptomatic bowel cancer will not improve survival in the majority of patients. However as excessive delays still occur in some patients it is reasonable to continue to aim to diagnose and treat all bowel cancer within 6 months of the onset of symptoms with an overall median of 3-4 months.

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Delays experienced by patients with symptomatic colorectal cancer

Abstract: Despite prompt GP consultation and out-patient referral, delays in the treatment of CRC now occur after referral to hospital. Patients referred without mention of CRC wait longest. Colonoscopy and double contrast barium enema have not improved tumour staging at treatment.

Cited by 8 publications

References 8 publications

Symptom duration versus survival in non‐emergency colorectal cancer

Symptom duration versus survival in non‐emergency colorectal cancer

Factors related with symptom duration until diagnosis and treatment of symptomatic colorectal cancer

Earlier diagnosis and treatment of symptomatic bowel cancer: can it be achieved and how much will it improve survival?

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