Perceived diagnostic delay and cancer-related distress: a cross-sectional study of patients with colorectal cancer

Miles, Anne; McClements, Paula L.; Steele, Robert; Redeker, Claudia; Sevdalis, Nick; Wardle, Jane

doi:10.1002/pon.4093

Cited by 50 publications

(35 citation statements)

References 41 publications

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“…Findings from the study are also in alignment with the literature by indicating that fear about having a serious health condition is an important cause of anxiety among patients and family members waiting for diagnosis [27]. Also in accordance with the literature, findings showed that perceived long timelines add stress to an already stressful situation [28]. Consistent with previous research, participants associated delays with their inaction or late action in seeking medical attention [6], with their doctor's failure to correctly identify cancer symptoms [12,29], and with system inefficiencies including variable access to specialists and testing and limited coordination of care [30,31].…”

Section: Discussionsupporting

confidence: 84%

From symptom to cancer diagnosis: Perspectives of patients and family members in Alberta, Canada

et al. 2020

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Background Significant intervals from the identification of suspicious symptoms to a definitive diagnosis of cancer are common. Streamlining pathways to diagnosis may increase survival, quality of life post-treatment, and patient experience. Discussions of pathways to diagnosis from the perspective of patients and family members are crucial to advancing cancer diagnosis. Aim To examine the perspectives of a group of patients with cancer and family members in Alberta, Canada, on factors associated with timelines to diagnosis and overall experience. Methods A qualitative approach was used. In-depth, semi-structured interviews with patients with cancer (n = 18) and patient relatives (n = 5) were conducted and subjected to a thematic analysis. Findings Participants struggled emotionally in the diagnostic period. Relevant to their experience were: potentially avoidable delays, concerns about health status, and misunderstood investigation process. Participants emphasized the importance of their active involvement in the care process, and had unmet supportive care needs. Conclusion Psychosocial supports available to potential cancer patients and their families are minimal, and may be important for improved experiences before diagnosis. Access to other patients' lived experiences with the diagnostic process and with cancer, and an enhanced supportive

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Section: Discussionsupporting

confidence: 84%

From symptom to cancer diagnosis: Perspectives of patients and family members in Alberta, Canada

et al. 2020

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“…Delays in time to treatment initiation (TTI) for new cancer diagnoses are commonly known to cause patient anxiety and distress [1, 2, 3, 4]. Physicians often reassure patients that current wait times to initiate therapy will not impact long-term outcomes, but the evidence is conflicting.…”

Section: Introductionmentioning

confidence: 99%

Time to initial cancer treatment in the United States and association with survival over time: An observational study

et al. 2019

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Background Delays in time to treatment initiation (TTI) for new cancer diagnoses cause patient distress and may adversely affect outcomes. We investigated trends in TTI for common solid tumors treated with curative intent, determinants of increased TTI and association with overall survival. Methods and findings We utilized prospective data from the National Cancer Database for newly diagnosed United States patients with early-stage breast, prostate, lung, colorectal, renal and pancreas cancers from 2004–13. TTI was defined as days from diagnosis to first treatment (surgery, systemic or radiation therapy). Negative binomial regression and Cox proportional hazard models were used for analysis. The study population of 3,672,561 patients included breast (N = 1,368,024), prostate (N = 944,246), colorectal (N = 662,094), non-small cell lung (N = 363,863), renal (N = 262,915) and pancreas (N = 71,419) cancers. Median TTI increased from 21 to 29 days (P<0.001). Aside from year of diagnosis, determinants of increased TTI included care at academic center, race, education, prior history of cancer, transfer of facility, comorbidities and age. Increased TTI was associated with worsened survival for stages I and II breast, lung, renal and pancreas cancers, and stage I colorectal cancers, with hazard ratios ranging from 1.005 (95% confidence intervals [CI] 1.002–1.008) to 1.030 (95% CI 1.025–1.035) per week of increased TTI. Conclusions TTI has lengthened significantly and is associated with absolute increased risk of mortality ranging from 1.2–3.2% per week in curative settings such as early-stage breast, lung, renal and pancreas cancers. Studies of interventions to ease navigation and reduce barriers are warranted to diminish potential harm to patients.

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“…Heightening the fear of recurrence is an added concern that is particularly relevant to haematological cancer survivors, namely the difficulty in diagnosing their cancers. A study from the UK has shown that is not uncommon for the diagnosis period for haematological cancers to be long and protracted (Howell et al, ) and diagnostic delay has been shown to cause increased distress in other cancer patients (Miles et al, ; Risberg, Sørbye, Norum, & Wist, ). The concern regarding their prolonged diagnostic period was carried through to participants in the post‐treatment period and contributed to their increased self‐monitoring.…”

Section: Discussionmentioning

confidence: 99%

The nature and timing of distress among post-treatment haematological cancer survivors

2018

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Many people with haematological cancers will not meet the diagnostic criteria for a psychological disorder, but will still suffer distress during treatment and beyond. The current study aimed to explore the nature and timing of psychosocial distress experienced by haematological cancer survivors. Twenty‐three post‐treatment haematological cancer survivors participated in a semi‐structured interview. Data were analysed using thematic analysis which involved identifying, analysing and reporting themes. Four themes were identified: Apprehension about leaving the safety of the health care system comprises the struggles encountered when transitioning from patient to survivor, Uncertainty and life transitions in the post‐treatment period encompasses the changes survivors face when attempting to re‐enter their “normal” lives, Distress associated with ongoing physical problems or impairment describes issues associated with the ongoing physical sequelae, and Fear of recurrence encapsulates how the continuing threat of cancer recurrence impacted survivors. This study has found that distress is ongoing for many haematological cancer survivors in the post‐treatment period. It is imperative that distress is identified and support offered to those in need to prevent further psychosocial issues. It is especially important to consider the psychosocial needs of survivors in the post‐treatment stage who are discharged from the health system may be unsure where to seek help.

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Perceived diagnostic delay and cancer-related distress: a cross-sectional study of patients with colorectal cancer

Cited by 50 publications

References 41 publications

From symptom to cancer diagnosis: Perspectives of patients and family members in Alberta, Canada

From symptom to cancer diagnosis: Perspectives of patients and family members in Alberta, Canada

Time to initial cancer treatment in the United States and association with survival over time: An observational study

The nature and timing of distress among post-treatment haematological cancer survivors

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