ArticlePloS one2015
Diagnostic intervals and its association with breast, prostate, lung and colorectal cancer survival in England: historical cohort study using the Clinical Practice Research Datalink.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 6 of them syntheses that pooled it.
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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.
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.
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Who cites it
44 citing papers in PubMed, 6 syntheses or guidelines pooled it, 87 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
- Association between time-to-treatment and outcomes in non-small cell lung cancer: a systematic review.Thorax · 2022Pooled it
- Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review.BMJ global health · 2021Pooled 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
- Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar.Systematic reviews · 2019Pooled it
- Quantifying intervals to diagnosis in myeloma: a systematic review and meta-analysis.BMJ open · 2018Pooled it
- Diagnostic intervals and imaging use in lung cancer: a national real-world study in England.BMJ open respiratory research · 2026Article
- Delay of Systemic Therapy Confers a Survival Benefit in Patients with Stage IV Non-Small-Cell Lung Cancer.Cancers · 2025Article
- Recent strategies in diagnosis, screening, prevention, and treatment of breast cancer in young women.Discover oncology · 2025Review
- The effect of comorbidities on diagnostic interval for lung cancer in England: a cohort study using electronic health record data.British journal of cancer · 2024Article
- Wait times and breast cancer survival: a population-based retrospective cohort study using CanIMPACT data.Cancer causes & control : CCC · 2024Article
- Variations in Depression and Anxiety among Jordanian Women Undergoing Mastectomy and Reconstruction Surgery: Impact of Familial Support.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Income differences in time to colon cancer diagnosis.Cancer medicine · 2024Article
- Survival analysis and clinicopathological features of patients with stage IA lung adenocarcinoma.Heliyon · 2024Article
- An Updated Insight into Phytomolecules and Novel Approaches used in the Management of Breast Cancer.Current drug targets · 2024Review
- Are Diagnostic Delays Associated with Distress in Breast Cancer Patients?Breast care (Basel, Switzerland) · 2023Article
- Article
- Identification, characterization, and prognosis investigation of pivotal genes shared in different stages of breast cancer.Scientific reports · 2023Article
- Article
- Associations of Symptom Clusters and Health Outcomes in Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
Rapid diagnostic pathways for cancer have been implemented, but evidence whether shorter diagnostic intervals (time from primary care presentation to diagnosis) improves survival is lacking. Using the Clinical Practice Research Datalink, we identified patients diagnosed with female breast (8,639), colorectal (5,912), lung (5,737) and prostate (1,763) cancers between 1998 and 2009, and aged >15 years. Presenting symptoms were classified as alert or non-alert, according to National Institute for Health and Care Excellence guidance. We used relative survival and excess risk modeling to determine associations between diagnostic intervals and five-year survival. The survival of patients with colorectal, lung and prostate cancer was greater in those with alert, compared with non-alert, symptoms, but findings were opposite for breast cancer. Longer diagnostic intervals were associated with lower mortality for colorectal and lung cancer patients with non-alert symptoms, (colorectal cancer: Excess Hazards Ratio, EHR >6 months vs <1 month: 0.85; 95% CI: 0.72-1.00; Lung cancer: EHR 3-6 months vs <1 month: 0.87; 95% CI: 0.80-0.95; EHR >6 months vs <1 month: 0.81; 95% CI: 0.74-0.89). Prostate cancer mortality was lower in patients with longer diagnostic intervals, regardless of type of presenting symptom. The association between diagnostic intervals and cancer survival is complex, and should take into account cancer site, tumour biology and clinical practice. Nevertheless, unnecessary delay causes patient anxiety and general practitioners should continue to refer patients with alert symptoms via the cancer pathways, and actively follow-up patients with non-alert symptoms in the community.
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