ArticleBritish journal of cancer2015
Symptom lead times in lung and colorectal cancers: what are the benefits of symptom-based approaches to early diagnosis?
Article in British journal of cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 4 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- 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
- Speech and language therapy for management of chronic cough.The Cochrane database of systematic reviews · 2019Pooled it
- Weight loss as a predictor of cancer in primary care: a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Pooled it
- Immediate chest X-ray for patients at risk of lung cancer presenting in primary care: randomised controlled feasibility trial.British journal of cancer · 2017Trial
- Diagnostic Delays in Thoracic Cancer Care: A Data-Linkage, Cohort Study between Primary Care, Hospital, and Registry Data.Health data science · 2026Article
- Improving the timeliness of care for regional lung cancer patients through the implementation of a web-based lung cancer referral pathway.Internal medicine journal · 2025Article
- Triaging colorectal urgent referrals in the COVID-19 era using faecal immunochemical testing: a prospective UK real-world multicentre cohort study.BMJ open gastroenterology · 2025Observational
- The incidence of lung cancer amongst primary care chest radiograph referrals-an evaluation of national and local datasets within the United Kingdom.The British journal of radiology · 2024Article
- Early-stage lung cancer associated with higher frequency of chest x-ray up to three years prior to diagnosis.Primary health care research & development · 2022Article
- Guideline interval: A new time interval in the diagnostic pathway for symptomatic cancer.Cancer epidemiology · 2021Article
- Time from presentation to pre-diagnostic chest X-ray in patients with symptomatic lung cancer: a cohort study using electronic patient records from English primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Association between use of urgent suspected cancer referral and mortality and stage at diagnosis: a 5-year national cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Presentation of lung cancer in primary care.NPJ primary care respiratory medicine · 2019Article
- Use of Healthcare Services Two Years before Diagnosis in Danish Sarcoma Patients, 2000-2013.Sarcoma · 2019Article
- Article
- Depression and Health Care Utilization at End of Life Among Older Adults With Advanced Non-Small-Cell Lung Cancer.Journal of pain and symptom management · 2018Article
- Clinical features of patients with non-metastatic lung cancer in primary care: a case-control study.BJGP open · 2018Article
- Health care use before a diagnosis of primary intracranial tumor: a Danish nationwide register study.Clinical epidemiology · 2018Article
- Prevalence of and risk factors for presenting initial respiratory symptoms in patients undergoing surgery for lung cancer.Journal of Cancer · 2018Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundIndividuals with undiagnosed lung and colorectal cancers present with non-specific symptoms in primary care more often than matched controls. Increased access to diagnostic services for patients with symptoms generates more early-stage diagnoses, but the mechanisms for this are only partially understood.
methodsWe re-analysed a UK-based case-control study to estimate the Symptom Lead Time (SLT) distribution for a range of potential symptom criteria for investigation. Symptom Lead Time is the time between symptoms caused by cancer and eventual diagnosis, and is analogous to Lead Time in a screening programme. We also estimated the proportion of symptoms in lung and colorectal cancer cases that are actually caused by the cancer.
resultsMean Symptom Lead Times were between 4.1 and 6.0 months, with medians between 2.0 and 3.2 months. Symptom Lead Time did not depend on stage at diagnosis, nor which criteria for investigation are adopted. Depending on the criteria, an estimated 27-48% of symptoms in individuals with as yet undiagnosed lung cancer, and 12-32% with undiagnosed colorectal cancer are not caused by the cancer.
conclusionsIn most cancer cases detected by a symptom-based programme, the symptoms are caused by cancer. These cases have a short lead time and benefit relatively little. However, in a significant minority of cases cancer detection is serendipitous. This group experiences the benefits of a standard screening programme, a substantial mean lead time and a higher probability of early-stage diagnosis.
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