ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2013
Are alarm symptoms predictive of cancer survival?: population-based cohort study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- The effect of time before diagnosis and treatment on colorectal cancer outcomes: systematic review and dose-response meta-analysis.British journal of cancer · 2023Pooled it
- Cancer diagnostic tools to aid decision-making in primary care: mixed-methods systematic reviews and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2020Pooled it
- Association of symptoms at diagnosis with prognosis in patients with surgically treated stage I non-small cell lung cancer: a retrospective cohort analysis of a prospectively maintained registry.Translational lung cancer research · 2026Article
- The Stockholm early detection of cancer study (STEADY-CAN): rationale, design, data collection, and baseline characteristics for 2.7 million participants.European journal of epidemiology · 2025Article
- The SYMPTOM-upper gastrointestinal study: A mixed methods study exploring symptom appraisal and help-seeking in Australian upper gastrointestinal cancer patients.European journal of cancer care · 2022Article
- Does Preoperative Waiting Time Affect the Short-Term Outcomes and Prognosis of Colorectal Cancer Patients? A Retrospective Study from the West of China.Canadian journal of gastroenterology & hepatology · 2022Article
- Effect of pre-existing conditions on bladder cancer stage at diagnosis: a cohort study using electronic primary care records in the UK.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Observational
- Delays in referral from primary care worsen survival for patients with colorectal cancer: a retrospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Impact of travel time and rurality on presentation and outcomes of symptomatic colorectal cancer: a cross-sectional cohort study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- Symptoms and patient factors associated with diagnostic intervals for pancreatic cancer (SYMPTOM pancreatic study): a prospective cohort study.The lancet. Gastroenterology & hepatology · 2016Observational
- Symptoms and patient factors associated with longer time to diagnosis for colorectal cancer: results from a prospective cohort study.British journal of cancer · 2016Article
- Effect of diagnostic delay on survival in patients with colorectal cancer: a retrospective cohort study.BMC cancer · 2016Observational
- Number of Gastrointestinal Symptoms is a Useful Means of Identifying Patients with Cancer for Dysphagia.Dysphagia · 2016Article
- Use of the English urgent referral pathway for suspected cancer and mortality in patients with cancer: cohort study.BMJ (Clinical research ed.) · 2015Article
- Article
- Critical items for assessing risk of lung and colorectal cancer in primary care: a Delphi study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlarm symptom presentations are predictive of cancer diagnosis but may also be associated with cancer survival.
aimTo evaluate diagnostic time intervals, and consultation patterns after presentation with alarm symptoms, and their association with cancer diagnosis and survival. DESIGN AND
settingCohort study using the Clinical Practice Research Database, with linked Cancer Registry data, in 158 general practices.
methodParticipants included those with haematuria, haemoptysis, dysphagia, and rectal bleeding or urinary tract cancer, lung cancer, gastro-oesophageal cancer, and colorectal cancer.
resultsThe median (interquartile range) interval in days from first symptom presentation to the corresponding cancer diagnosis was: haematuria and urinary tract cancer, 59 (28-109); haemoptysis and lung cancer, 35 (18-89); dysphagia and gastro-oesophageal cancer, 25 (12-48); rectal bleeding and colorectal cancer, 49 (20-157). Three or more alarm symptom consultations were associated with increased odds of diagnosis of urinary tract cancer (odds ratio [OR] 1.84, 95% CI = 1.50 to 2.27), lung cancer (OR = 1.76, 95% CI = 1.07 to 2.90) and gastro-oesophageal cancer (OR = 2.17, 95% CI = 1.48 to 3.19). Longer diagnostic intervals were associated with increased mortality only for urinary tract cancer (hazard ratio 2.23, 95% CI = 1.35 to 3.69). Patients with no preceding alarm symptom had shorter survival from diagnosis of urinary tract, lung or colorectal cancer than those presenting with a relevant alarm symptom.
conclusionAfter alarm symptom presentation, repeat consultations are associated with cancer diagnoses. Longer diagnostic intervals appeared to be associated with a worse prognosis for urinary tract cancer only. Mortality is higher when cancer is diagnosed in the absence of alarm symptoms.
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