Evidence map›Paper›PMID 25734397›Full record

ArticleBritish journal of cancer2015

Symptoms and other factors associated with time to diagnosis and stage of lung cancer: a prospective cohort study.

F M Walter, G Rubin, C Bankhead, H C Morris, N Hall, K Mills, C Dobson, R C Rintoul, W Hamilton, J Emery

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

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 113 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
113citing papers in PubMed, 7 pooled it
13.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

113 citing papers in PubMed, 7 syntheses or guidelines pooled it, 226 citations in OpenAlex.

  1. Patient navigation programmes for symptomatic lung cancer patients: a scoping review.Archives of public health = Archives belges de sante publique · 2025
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53 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 2 countries.

F M Walter1] Department of Public Health & Primary Care, University of Cambridge, Cambridge CB1 8RN, UK [2] General Practice & Primary Care Academic Centre, University of Melbourne, Melbourne, Victoria, Australia.
G RubinSchool of Medicine, Pharmacy & Health, Durham University, Wolfson Building, Stockton on Tees TS17 6BH, UK.
C BankheadNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
H C MorrisDepartment of Public Health & Primary Care, University of Cambridge, Cambridge CB1 8RN, UK.
N HallSchool of Medicine, Pharmacy & Health, Durham University, Wolfson Building, Stockton on Tees TS17 6BH, UK.
K MillsDepartment of Public Health & Primary Care, University of Cambridge, Cambridge CB1 8RN, UK.
C DobsonSchool of Medicine, Pharmacy & Health, Durham University, Wolfson Building, Stockton on Tees TS17 6BH, UK.
R C RintoulDepartment of Thoracic Oncology, Papworth Hospital NHS Foundation Trust, Cambridge CB23 3RE, UK.
W HamiltonUniversity of Exeter, College House, St Luke's Campus, Exeter EX2 4TE, UK.
J Emery1] Department of Public Health & Primary Care, University of Cambridge, Cambridge CB1 8RN, UK [2] General Practice & Primary Care Academic Centre, University of Melbourne, Melbourne, Victoria, Australia [3] Department of General Practice, University of Western Australia, Perth, Western Australia, Australia.
Durham University · GBUniversity of Cambridge · GBPapworth Hospital NHS Foundation Trust · GBUniversity of Exeter · GBUniversity of Oxford · GBUniversity of Western Australia · AU

Funding

Department of Health RP-PG-0608-10045
6 · The paper itself

Abstract

backgroundThis prospective cohort study aimed to identify symptom and patient factors that influence time to lung cancer diagnosis and stage at diagnosis.

methodsData relating to symptoms were collected from patients upon referral with symptoms suspicious of lung cancer in two English regions; we also examined primary care and hospital records for diagnostic routes and diagnoses. Descriptive and regression analyses were used to investigate associations between symptoms and patient factors with diagnostic intervals and stage.

resultsAmong 963 participants, 15.9% were diagnosed with primary lung cancer, 5.9% with other thoracic malignancies and 78.2% with non-malignant conditions. Only half the cohort had an isolated first symptom (475, 49.3%); synchronous first symptoms were common. Haemoptysis, reported by 21.6% of cases, was the only initial symptom associated with cancer. Diagnostic intervals were shorter for cancer than non-cancer diagnoses (91 vs 124 days, P=0.037) and for late-stage than early-stage cancer (106 vs 168 days, P=0.02). Chest/shoulder pain was the only first symptom with a shorter diagnostic interval for cancer compared with non-cancer diagnoses (P=0.003).

conclusionsHaemoptysis is the strongest symptom predictor of lung cancer but occurs in only a fifth of patients. Programmes for expediting earlier diagnosis need to focus on multiple symptoms and their evolution.

Indexed as

AdultAgedAged, 80 and overCarcinomaChest PainCohort StudiesCoughDelayed DiagnosisDyspneaEnglandFemaleHemoptysisHumansLung DiseasesLung NeoplasmsMale

Identifiers

PMID25734397
PMCPMC4385970
OpenAlexW2087959032

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.