Symptom-to-diagnosis interval and survival in cancers of the digestive tract |
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Authors: | Fernandez Esteve Porta Miquel Malats Núria Belloc Josep Gallén Manuel |
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Affiliation: | (1) Institut Català d'Oncologia, L'Hospitalet, Barcelona, Spain;(2) Universitat de Barcelona, Barcelona, Spain;(3) Universitat Autònoma de Barcelona, Barcelona, Spain;(4) Institut Municipal d'Investigació Mèdica, Barcelona, Spain;(5) Univesitat Pompeu Fabra, Barcelona, Spain;(6) Department of Gastroenterology, Hospital del Mar, Barcelona, Spain;(7) Department of Oncology, Hospital del Mar, Barcelona, Spain |
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Abstract: | The objective was to identify the main correlates of the symptom-to-diagnosis interval (SDI) and to analyze their influence upon the survival in patients with cancers of the digestive tract. Two hundred forty-eight symptomatic patients with cancer of the esophagus (N = 31), stomach (N = 70), colon (N = 84), and rectum (N = 66) were interviewed and prospectively followed (median follow-up of 77 months). Cox's regression was used to assess the relative risk (RR) of death according to SDI. The median SDI was about 4 months, with nonsignificant differences by sex, age, social class, family history of cancer, or tumor site. The RR of death varied significantly by age (P = 0.012), tumor site (P < 0.01), tumor stage (P < 0.01), and type of hospital admission (P < 0.01). After adjustment for known and potential predictors of survival and as compared to an SDI < 2.5 months, the RR of death was 0.89 (95% CI: 0.61–1.32) for an SDI of 2.5–6 months, 0.78 (95% CI: 0.49–1.26) for SDI > 6–12 months, and 0.81 (95% CI: 0.44–1.49) for SDI > 12 months. These results do not imply that specific actions to hasten diagnosis must of necessity be ineffective, but underscore what a challenging task the secondary prevention of cancer remains. |
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Keywords: | gastrointestinal neoplasms diagnosis symptom duration delay, prognosis survival healthcare-seeking behavior |
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