Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review
Diagnostic interval and mortality in colorectal cancer : U-shaped association demonstrated for three different datasets. / Tørring, Marie Louise; Frydenberg, Morten; Hamilton, William; Hansen, Rikke Pilegaard; Lautrup, Marianne Djernes; Vedsted, Peter.
I: Journal of Clinical Epidemiology, Bind 65, Nr. 6, 27.03.2012, s. 669-678.Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review
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TY - JOUR
T1 - Diagnostic interval and mortality in colorectal cancer
T2 - U-shaped association demonstrated for three different datasets
AU - Tørring, Marie Louise
AU - Frydenberg, Morten
AU - Hamilton, William
AU - Hansen, Rikke Pilegaard
AU - Lautrup, Marianne Djernes
AU - Vedsted, Peter
PY - 2012/3/27
Y1 - 2012/3/27
N2 - ObjectiveTo test the theory of a U-shaped association between time from the first presentation of symptoms in primary care to the diagnosis (the diagnostic interval) and mortality after diagnosis of colorectal cancer (CRC).Study Design and SettingThree population-based studies in Denmark and the United Kingdom using data from general practitioner’s questionnaires, interviewer-administered patient questionnaires, and primary care records, respectively.ResultsDespite variations in the potential selection and information bias when using different methods of identifying the date of first presentation, the association between the length of the diagnostic interval and 5-year mortality rate after the diagnosis of CRC was the same for all three types of data: displaying a U-shaped association with decreasing and subsequently increasing mortality with longer diagnostic intervals.ConclusionUnknown confounding and in particular confounding by indication is likely to explain the counterintuitive findings of higher mortality among patients with very short diagnostic intervals, but cannot explain the increasing mortality with longer diagnostic intervals. The results support the theory that longer diagnostic intervals cause higher mortality in patients with CRC.
AB - ObjectiveTo test the theory of a U-shaped association between time from the first presentation of symptoms in primary care to the diagnosis (the diagnostic interval) and mortality after diagnosis of colorectal cancer (CRC).Study Design and SettingThree population-based studies in Denmark and the United Kingdom using data from general practitioner’s questionnaires, interviewer-administered patient questionnaires, and primary care records, respectively.ResultsDespite variations in the potential selection and information bias when using different methods of identifying the date of first presentation, the association between the length of the diagnostic interval and 5-year mortality rate after the diagnosis of CRC was the same for all three types of data: displaying a U-shaped association with decreasing and subsequently increasing mortality with longer diagnostic intervals.ConclusionUnknown confounding and in particular confounding by indication is likely to explain the counterintuitive findings of higher mortality among patients with very short diagnostic intervals, but cannot explain the increasing mortality with longer diagnostic intervals. The results support the theory that longer diagnostic intervals cause higher mortality in patients with CRC.
KW - Forsinket diagnose
KW - Ventelister
KW - Dødelighed
KW - Primær sektor
KW - Kolorektalkræft
KW - Bias
KW - Delayed diagnosis
KW - Waiting lists
KW - Mortality
KW - Colorectal cancer
KW - Primary Health Care
KW - Bias
U2 - 10.1016/j.jclinepi.2011.12.006
DO - 10.1016/j.jclinepi.2011.12.006
M3 - Journal article
C2 - 22459430
VL - 65
SP - 669
EP - 678
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
SN - 0895-4356
IS - 6
ER -