期刊
EUROPEAN JOURNAL OF CANCER
卷 154, 期 -, 页码 269-276出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2021.06.020
关键词
Colorectal neoplasm; Delayed diagnosis; Age groups; Symptoms
类别
资金
- Swedish Research Council [2017-01103]
- Swedish Cancer Society [CAN 2016/509, 19 0333 Pj]
- Swedish Society of Medicine [SLS693371]
- Healthcare subcommittee of Region Vastra Gotaland [VGFOUREG-308861, VGFOUREG-374491, VGRFOUREG-644441, VGFOUREG-557431, VGRFOUREG-733172, VGFOUREG-468731]
- ALF grant `Agreement concerning research and education of doctors' [ALFGBG-426501, ALFGBG-716581, ALFGBG-493341]
- Anna-Lisa and Bror Bjornssons Foundation
- Assar Gabrielsson Foundation
- Lion's Cancer Research Foundation of Western Sweden
- Mary von Sydow Foundation
- Ruth and Richard Julin's Foundation
- Gothenburg Medical Society
Younger age at diagnosis of colorectal cancer is associated with a diagnostic delay, while symptomatology at diagnosis remains similar regardless of age. Younger patients are more likely to report specific symptoms such as blood in stool and diarrhea.
Aim: This study aimed to investigate if younger age at diagnosis of colorectal cancer was associated with a diagnostic delay. The secondary objective was to evaluate if symptomatology varied with age. Method: The study population consisted of the cohorts from two prospective multicentre studies conducted in Sweden and Denmark, the QoLiRECT and QoLiCOL studies. These studies investigated the quality of life in patients with colorectal cancer. Participants responded to the validated questionnaires used to extract information on patient's and doctor's delay as well as first presenting symptoms. Clinical variables were retrieved from the Swedish Colorectal Cancer Registry and the Danish Colorectal Cancer Group Database. Results: 2574 patients were included, 1085 from QoLiRECT and 1489 from QoLiCOL. The probability of an increased patient's delay was higher when age decreased by 10 years (the SD in both QoLiRECT and QoLiCOL), adjusted OR 1.19 (95%CI: 1.10; 1.30), p < 0.001. A similar effect was found for doctor's delay, but the age effect was smaller in this case, adjusted OR 1.05 (95%CI: 0.97; 1.15), p Z 0.177. When the age effect was analysed non linearly, an increased probability of a delay was seen for patients from around 60 years and below. Younger patients were equally or more likely to report the symptoms of blood in stool, diarrhoea, constipation, mucus in faeces, faecal urgency, faecal emptying difficulties and pain compared to older patients. Conclusion: Younger patients were more likely to have an increased patient's delay, probably contributing to a delayed diagnosis of colorectal cancer. Symptomatology at diagnosis was similar irrespective of age. (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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