Evidence map›Paper›PMID 28494470›Full record

ArticleBritish journal of cancer2017

Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records.

Luke T A Mounce, Sarah Price, Jose M Valderas, William Hamilton

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

Article in British journal of cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 2 pooled it
5.9field-weighted citation impact, top 3% 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

55 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.

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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

4 authors at 2 institutions in 1 country.

Luke T A MounceResearch Fellow, Health Services and Policy Research Group, Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School, South Cloisters, St Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK.
Sarah PriceResearch Fellow, Diagnosis of Symptomatic Cancer Optimally (DISCO) and Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School, College House, St Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK.
Jose M ValderasProfessor of Health Services and Policy Research, Health Services and Policy Research Group, Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School, Smeall Building, St Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK.
William HamiltonProfessor of Primary Care Diagnostics, Diagnosis of Symptomatic Cancer Optimally (DISCO) and Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School, College House, St Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK.
University of Exeter · GBExeter Primary Care · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPre-existing non-cancer conditions may complicate and delay colorectal cancer diagnosis.

methodIncident cases (aged ⩾40 years, 2007-2009) with colorectal cancer were identified in the Clinical Practice Research Datalink, UK. Diagnostic interval was defined as time from first symptomatic presentation of colorectal cancer to diagnosis. Comorbid conditions were classified as 'competing demands' (unrelated to colorectal cancer) or 'alternative explanations' (sharing symptoms with colorectal cancer). The association between diagnostic interval (log-transformed) and age, gender, consultation rate and number of comorbid conditions was investigated using linear regressions, reported using geometric means.

resultsOut of the 4512 patients included, 72.9% had ⩾1 competing demand and 31.3% had ⩾1 alternative explanation. In the regression model, the numbers of both types of comorbid conditions were independently associated with longer diagnostic interval: a single competing demand delayed diagnosis by 10 days, and four or more by 32 days; and a single alternative explanation by 9 days. For individual conditions, the longest delay was observed for inflammatory bowel disease (26 days; 95% CI 14-39).

conclusionsThe burden and nature of comorbidity is associated with delayed diagnosis in colorectal cancer, particularly in patients aged ⩾80 years. Effective clinical strategies are needed for shortening diagnostic interval in patients with comorbidity.

Indexed as

Delayed DiagnosisAbdominal PainAdultAgedAged, 80 and overAnemiaAnxietyCohort StudiesColorectal NeoplasmsComorbidityCoronary DiseaseDepressionDiagnosis, DifferentialDiverticulumFemaleGastrointestinal Hemorrhage

Identifiers

PMID28494470
PMCPMC5518856
OpenAlexW2613062090

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

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.