ArticleBritish journal of cancer2017
Evidence of advanced stage colorectal cancer with longer diagnostic intervals: a pooled analysis of seven primary care cohorts comprising 11 720 patients in five countries.
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 56 papers, 3 of them syntheses that pooled it.
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Who cites it
56 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prophylactic Intraperitoneal Chemotherapy with Platinum Agents Following Curative Resection for Colorectal Cancer: A Systematic Review and Meta-Analysis.Annals of surgical oncology · 2026Pooled it
- 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
- Delay to elective colorectal cancer surgery and implications for survival: a systematic review and meta-analysis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Pooled it
- Prediagnostic primary care consultations and imaging in emergency-diagnosed versus referred patients with lung cancer: a population-based linked data study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Undiagnosed Sacrococcygeal Fistulas: A Case Report.Cureus · 2026Article
- Time to Treatment Initiation of Lung, Breast, Colorectal, and Prostate Cancers and Contributing Factors From 2015 to 2020 Utilizing Surveillance, Epidemiology, and End Results Program Database.World journal of oncology · 2025Article
- Awareness of cervical cancer risk factors and preventive approaches, and perceived causes of cervical cancer among secondary school girls: a cross-sectional study in Northern Uganda.Annals of medicine · 2024Article
- 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
- Income differences in time to colon cancer diagnosis.Cancer medicine · 2024Article
- Understanding Colorectal Cancer Patient Experiences with Family Practitioners in Canada.Current oncology (Toronto, Ont.) · 2024Article
- Risk of cancer and serious disease in Danish patients with urgent referral for serious non-specific symptoms and signs of cancer in Funen 2014-2021.British journal of cancer · 2024Article
- Stage at diagnosis of colorectal cancer through diagnostic route: Who should be screened?World journal of gastroenterology · 2024Observational
- Determining factors of presentation and diagnosis delays in patients with colorectal cancer and the impact on stage: a cross sectional study in Yogyakarta, Indonesia.Ecancermedicalscience · 2024Article
- Adopting standardized cancer patient pathways as a policy at different organizational levels in the Swedish Health System.Health research policy and systems · 2023Article
- Factors associated with diagnostic and pre-treatment intervals among breast cancer patients attending care at the Uganda Cancer Institute: A cross-sectional study.Cancer medicine · 2023Article
- Fecal occult blood and calprotectin testing to prioritize primary care patients for colonoscopy referral: The advantage study.United European gastroenterology journal · 2023Article
- Analysis of Time to Treatment and Survival Among Adults Younger Than 50 Years of Age With Colorectal Cancer in Canada.JAMA network open · 2023Article
- The association between sociodemographic factors and time to diagnosis for colorectal cancer in northern Sweden.European journal of cancer care · 2022Article
- How does social context influence appraisal and help-seeking for potential cancer symptoms in adults aged 50 and over? A qualitative interview study.European journal of cancer care · 2022Article
- Relationship between time from symptom's onset to diagnosis and prognosis in patients with symptomatic colorectal cancer.BMC cancer · 2022Article
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe benefits from expedited diagnosis of symptomatic cancer are uncertain. We aimed to analyse the relationship between stage of colorectal cancer (CRC) and the primary and specialist care components of the diagnostic interval.
methodsWe identified seven independent data sets from population-based studies in Scotland, England, Canada, Denmark and Spain during 1997-2010 with a total of 11 720 newly diagnosed CRC patients, who had initially presented with symptoms to a primary care physician. Data were extracted from patient records, registries, audits and questionnaires, respectively. Data sets were required to hold information on dates in the diagnostic interval (defined as the time from the first presentation of symptoms in primary care until the date of diagnosis), symptoms at first presentation in primary care, route of referral, gender, age and histologically confirmed stage. We carried out reanalysis of all individual data sets and, using the same method, analysed a pooled individual patient data set.
resultsThe association between intervals and stage was similar in the individual and combined data set. There was a statistically significant convex (∩-shaped) association between primary care interval and diagnosis of advanced (i.e., distant or regional) rather than localised CRC (P=0.004), with odds beginning to increase from the first day on and peaking at 90 days. For specialist care, we saw an opposite and statistically significant concave (∪-shaped) association, with a trough at 60 days, between the interval and diagnosis of advanced CRC (P<0.001).
conclusionsThis study provides evidence that longer diagnostic intervals are associated with more advanced CRC. Furthermore, the study cannot define a specific 'safe' waiting time as the length of the primary care interval appears to have negative impact from day one.
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