Why so late?!—delay in treatment of colorectal cancer is socially determined

Langenbach, Marc; Sauerland, Stefan; Kröbel, Karl-Wilhelm; Zirngibl, Hubert

doi:10.1007/s00423-010-0664-8

Cited by 26 publications

(19 citation statements)

References 28 publications

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“…Colorectal cancer (CRC) is globally a leading cause of cancer-related death [ 1 ]. Surgery, i. e., hemicolectomy in colon cancer or total mesorectal excision with extended lymphadenectomy, is the only curative option in locally confined stages of cancers and is reasonable when the tumor has exceeded the mucosal layer [ 2 ]. Tumors that are limited to the intestinal wall without lymph node invasion (Union for International Cancer Control (UICC) stage I–II) are primarily operated while higher stages are usually pretreated by radiation combined with a 5-fluorouracil-based chemotherapy (UICC stage III–IV) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Extensive screening of microRNA populations identifies hsa-miR-375 and hsa-miR-133a-3p as selective markers for human rectal and colon cancer

et al. 2018

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MicroRNAs (miRNAs) are ∼22-nt molecules exerting control of protein expression in cancer tissues. The current study determined the full spectrum of miRNA dysregulation in freshly isolated human colon or rectal cancer biopsies as well as in controls of healthy adjacent tissue (total of n = 100) using an Illumina sequencing technology. In this work, we aimed to identify miRNAs that may serve as future marker to discern between these two subtypes. DESeq2 analysis revealed 53 significantly dysregulated miRNAs in colon cancer, 67 miRNAs in rectal cancer, and 97 miRNAs in both at a Padj value < 0.05 and ≥ 10 read counts. 65% of miRNAs were upregulated in colon as well as rectal cancer. Highest significant dysregulation (Padj < 0.00001) was detected for hsa-miR-21-5p, -215-5p and -378a in both colon and rectal cancer. Among the group of miRNAs with Padj < 0.05 and more than 2-fold expression differences, hsa-miR-375 was detected in rectal cancer only, and hsa-miR-133a-3p only in colon cancer. Receiver operating characteristic (ROC) analysis confirmed highly distinct sensitivities for hsa-miR-375 to detect rectal cancer (area under the curve (AUC): 0.9), while hsa-miR-133a-3p (AUC: 0.89) had the highest sensitivity for detecting colon cancer. We conclude that hsa-miR-375 and hsa-miR-133a-3p may serve as new markers of rectal or colon cancer and should be further investigated to search for different etiologies of colorectal cancer.

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Section: Introductionmentioning

confidence: 99%

Extensive screening of microRNA populations identifies hsa-miR-375 and hsa-miR-133a-3p as selective markers for human rectal and colon cancer

et al. 2018

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“…Median data reported by Esteva et al [24] in colorectal cancer have been similar to our results. Further figures are also available for colorectal cancer [25] and lung cancer [26][27][28] in the literature; however, these studies report median data on treatment delay from first suspicion/visit/ symptom onset instead of first diagnosis; therefore, they result in higher delays. To facilitate weighing the cost of care of a patient with cancer, we compared it with the cost of care of a patient with hemophilia.…”

Section: Type Of Cancermentioning

confidence: 89%

Prognosis, Cost, and Occurrence of Colorectal, Lung, Breast, and Prostate Cancer in Hungary

Inotai¹,

Abonyi‐Tóth

Rokszin

et al. 2015

Value in Health Regional Issues

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“…The results of our unadjusted analyses indicated that if it took longer than 4 months to seek medical attention after onset of symptoms the risk of experiencing lower quality of life was higher, although not significantly so once confounding factors had been included. It has been reported that prolongation of the time from onset of symptoms to the patient's first contact with the health‐care system can be influenced by several factors, including marital and insurance status .…”

Section: Discussionmentioning

confidence: 99%

Timely access to care in the treatment of rectal cancer and the effect on quality of life

et al. 2018

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Aim The aim of this study was to investigate if a delay in a patient's first contact with a healthcare professional, and any subsequent delay in diagnosis, affected selfassessed quality of life prior to start of treatment for rectal cancer.Method Questionnaires were administered when patients had been informed of the diagnosis and planned treatment. The primary end-point was self-assessed quality of life according to a seven-point Likert scale. The response variables were dichotomized and analysed by unadjusted and adjusted binary logistic regression.Results A reported duration of symptoms longer than 4 months was found to be associated with a lower quality of life than a reported duration of symptoms of less than 3 months. Furthermore, a reported period of longer than 2 months from first contact with a healthcare professional to a diagnosis was found to correlate with lower quality of life compared with a period shorter than 2 months. However, when adjusting for possible confounding variables the duration of symptoms and time to diagnosis were not found to affect self-assessed quality of life. Several variables were found to have significant influence in the statistical model, including sense of coherence, the presence of negative intrusive thoughts, comorbidity, depressed mood, male sex and comorbidity.Conclusion One conclusion of our study is that further efforts to shorten delay in rectal cancer care with the aim of improving quality of life may be futile. To improve the patient's quality of life at diagnosis other interventions should be considered, such as screening for depression and/or negative intrusive thoughts.Keywords Rectal cancer, quality of life, diagnostic delay, symptoms, health services accessibility What does this paper add to the literature? Improved survival rates in rectal cancer treatment have led to an increasing interest in quality of life. This study attempts to establish whether quality of life is affected by how long it takes from symptom onset to first contact with a healthcare professional and then before the diagnosis is confirmed.

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Why so late?!—delay in treatment of colorectal cancer is socially determined

Abstract: The delay in treatment of colorectal cancer depends on socioeconomic status and family background. Achieving equity in colorectal cancer detection may require consideration of high-risk subgroups.

Cited by 26 publications

References 28 publications

Extensive screening of microRNA populations identifies hsa-miR-375 and hsa-miR-133a-3p as selective markers for human rectal and colon cancer

Extensive screening of microRNA populations identifies hsa-miR-375 and hsa-miR-133a-3p as selective markers for human rectal and colon cancer

Prognosis, Cost, and Occurrence of Colorectal, Lung, Breast, and Prostate Cancer in Hungary

Timely access to care in the treatment of rectal cancer and the effect on quality of life

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