Journal
EUROPEAN JOURNAL OF CANCER CARE
Volume 28, Issue 5, Pages -Publisher
WILEY
DOI: 10.1111/ecc.13100
Keywords
bias; breast neoplasms; colorectal neoplasms; delayed diagnosis; diagnosis; early detection of cancer; lung neoplasms; ovarian neoplasms; primary health care; time factors; waiting lists
Funding
- Cancer Council Victoria Funding Source: Medline
- Danish Cancer Society Funding Source: Medline
- Public Health Agency NI Funding Source: Medline
- NHS England Funding Source: Medline
- Scottish Government Funding Source: Medline
- Victorian Department of Health and Human Services Funding Source: Medline
- Norwegian University of Science and Technology (NTNU) Funding Source: Medline
- Research Centre for Cancer Diagnosis in Primary Care (CaP) Funding Source: Medline
- Aarhus University Funding Source: Medline
- Northern Ireland Cancer Registry Funding Source: Medline
- Cancer Research Wales Funding Source: Medline
- CancerCare Manitoba Funding Source: Medline
- Swedish Association of Local Authorities and Regions Funding Source: Medline
- Guidelines Audit and Implementation Network (GAIN) Funding Source: Medline
- Danish Health and Medicines Authority Funding Source: Medline
- University of Edinburgh Funding Source: Medline
- National Cancer Action Team Funding Source: Medline
- Welsh Government Funding Source: Medline
- University College London Funding Source: Medline
- Norwegian Directorate of Health Funding Source: Medline
- European Palliative Care Research Centre (PRC) Funding Source: Medline
- Cancer Care Ontario Funding Source: Medline
- Macmillan Cancer Support Funding Source: Medline
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Objective To investigate the relationship between tumour stage at diagnosis and selected components of primary and secondary care in the diagnostic interval for breast, colorectal, lung and ovarian cancers. Methods Observational study based on data from 6,162 newly diagnosed symptomatic cancer patients from Module 4 of the International Cancer Benchmarking Partnership. We analysed the odds of advanced stage of cancer as a flexible function of the length of primary care interval (days from first presentation to referral) and secondary care interval (days from referral to diagnosis), respectively, using logistic regression with restricted cubic splines. Results The association between time intervals and stage was similar for each type of cancer. A statistically significant U-shaped association was seen between the secondary care interval and the diagnosis of advanced rather than localised cancer, odds decreasing from the first day onwards and increasing around three and a half months. A different pattern was seen for the primary care interval, flat trends for colorectal and lung cancers and a slightly curved association for ovarian cancer, although not statistically significant. Conclusion The results confirm previous findings that some cancers may progress even within the relatively short time frame of regulated diagnostic intervals. The study supports the current emphasis on expediting symptomatic diagnosis of cancer.
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