TY - JOUR

T1 - Advanced‐stage cancer and time to diagnosis:

T2 - An International Cancer Benchmarking Partnership (ICBP) cross‐sectional study

AU - Tørring, Marie Louise

AU - Falborg, Alina Zalounina

AU - Jensen, Henry

AU - Neal, Richard D

AU - Weller, David

AU - Reguilon, Irene

AU - The ICBP Working Group

AU - Menon, Usha

AU - Vedsted, Peter

PY - 2019/9

Y1 - 2019/9

N2 - 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.

AB - 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.

KW - bias

KW - breast neoplasms

KW - colorectal neoplasms

KW - delayed diagnosis

KW - diagnosis

KW - early detection of cancer

KW - lung neoplasms

KW - ovarian neoplasms

KW - primary health care

KW - time factors

KW - waiting lists

KW - WAITING TIME

KW - SURVIVAL IMPACT

KW - BREAST-CANCER

KW - LUNG-CANCER

KW - SYMPTOMATIC COLORECTAL-CANCER

KW - PRIMARY-CARE

KW - INTERVALS

KW - OUTCOMES

KW - DELAY

KW - ASSOCIATION

UR - http://www.scopus.com/inward/record.url?scp=85066875112&partnerID=8YFLogxK

U2 - 10.1111/ecc.13100

DO - 10.1111/ecc.13100

M3 - Journal article

C2 - 31119836

VL - 28

JO - European Journal of Cancer Care

JF - European Journal of Cancer Care

SN - 0961-5423

IS - 5

M1 - e13100

ER -