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Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care

BACKGROUND: The relationship between the diagnostic interval and mortality from colorectal cancer (CRC) is unclear. This association was examined by taking account of important confounding factors at the time of first presentation of symptoms in primary care. METHODS: A total of 268 patients with CR...

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Autores principales: Tørring, M L, Frydenberg, M, Hansen, R P, Olesen, F, Hamilton, W, Vedsted, P
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065288/
https://www.ncbi.nlm.nih.gov/pubmed/21364593
http://dx.doi.org/10.1038/bjc.2011.60
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author Tørring, M L
Frydenberg, M
Hansen, R P
Olesen, F
Hamilton, W
Vedsted, P
author_facet Tørring, M L
Frydenberg, M
Hansen, R P
Olesen, F
Hamilton, W
Vedsted, P
author_sort Tørring, M L
collection PubMed
description BACKGROUND: The relationship between the diagnostic interval and mortality from colorectal cancer (CRC) is unclear. This association was examined by taking account of important confounding factors at the time of first presentation of symptoms in primary care. METHODS: A total of 268 patients with CRC were included in a prospective, population-based study in a Danish county. The diagnostic interval was defined as the time from first presentation of symptoms until diagnosis. We analysed patients separately according to the general practitioner's interpretation of symptoms. Logistic regression was used to estimate 3-year mortality odds ratios as a function of the diagnostic interval using restricted cubic splines and adjusting for tumour site, comorbidity, age, and sex. RESULTS: In patients presenting with symptoms suggestive of cancer or any other serious illness, the risk of dying within 3 years decreased with diagnostic intervals up to 5 weeks and then increased (P=0.002). In patients presenting with vague symptoms, the association was reverse, although not statistically significant. CONCLUSION: Detecting cancer in primary care is two sided: aimed at expediting ill patients while preventing healthy people from going to hospital. This likely explains the counterintuitive findings; but it does not explain the increasing mortality with longer diagnostic intervals. Thus, this study provides evidence for the hypothesis that the length of the diagnostic interval affects mortality in CRC patients.
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spelling pubmed-30652882011-05-12 Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care Tørring, M L Frydenberg, M Hansen, R P Olesen, F Hamilton, W Vedsted, P Br J Cancer Clinical Study BACKGROUND: The relationship between the diagnostic interval and mortality from colorectal cancer (CRC) is unclear. This association was examined by taking account of important confounding factors at the time of first presentation of symptoms in primary care. METHODS: A total of 268 patients with CRC were included in a prospective, population-based study in a Danish county. The diagnostic interval was defined as the time from first presentation of symptoms until diagnosis. We analysed patients separately according to the general practitioner's interpretation of symptoms. Logistic regression was used to estimate 3-year mortality odds ratios as a function of the diagnostic interval using restricted cubic splines and adjusting for tumour site, comorbidity, age, and sex. RESULTS: In patients presenting with symptoms suggestive of cancer or any other serious illness, the risk of dying within 3 years decreased with diagnostic intervals up to 5 weeks and then increased (P=0.002). In patients presenting with vague symptoms, the association was reverse, although not statistically significant. CONCLUSION: Detecting cancer in primary care is two sided: aimed at expediting ill patients while preventing healthy people from going to hospital. This likely explains the counterintuitive findings; but it does not explain the increasing mortality with longer diagnostic intervals. Thus, this study provides evidence for the hypothesis that the length of the diagnostic interval affects mortality in CRC patients. Nature Publishing Group 2011-03-15 2011-03-01 /pmc/articles/PMC3065288/ /pubmed/21364593 http://dx.doi.org/10.1038/bjc.2011.60 Text en Copyright © 2011 Cancer Research UK https://creativecommons.org/licenses/by-nc-sa/3.0/This work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
spellingShingle Clinical Study
Tørring, M L
Frydenberg, M
Hansen, R P
Olesen, F
Hamilton, W
Vedsted, P
Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care
title Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care
title_full Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care
title_fullStr Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care
title_full_unstemmed Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care
title_short Time to diagnosis and mortality in colorectal cancer: a cohort study in primary care
title_sort time to diagnosis and mortality in colorectal cancer: a cohort study in primary care
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065288/
https://www.ncbi.nlm.nih.gov/pubmed/21364593
http://dx.doi.org/10.1038/bjc.2011.60
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