Evidence map›Paper›PMID 36959641›Full record

ArticleBMC health services research2023

Use of health services one year before primary colorectal cancer.

Elina Hermiö, Karri Seppä, Heidi Ryynänen, Elli Hirvonen, Liisa Pylkkänen, Jutta Järvelin, Nea Malila, Janne Pitkäniemi

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Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

8 authors.

Elina HermiöUnit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, 33014, Finland. elina.hermio@tuni.fi.
Karri SeppäCancer Society of Finland, Unioninkatu 22, 00130, Helsinki, Finland.
Heidi RyynänenCancer Society of Finland, Unioninkatu 22, 00130, Helsinki, Finland.
Elli HirvonenCancer Society of Finland, Unioninkatu 22, 00130, Helsinki, Finland.
Liisa PylkkänenUniversity of Turku, 20014 Turun Yliopisto, Turku, Finland.
Jutta JärvelinFinnish Institute for Health and Welfare, PL 30, 00271, Helsinki, Finland.
Nea MalilaCancer Society of Finland, Unioninkatu 22, 00130, Helsinki, Finland.
Janne PitkäniemiUnit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, 33014, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundColorectal cancer (CRC) patient pathways focus typically on periods after confirmed diagnosis and only limited data are available on pathways prior to cancer diagnosis. The aim of the study was to describe the use of health services (HS) one year before diagnosis among CRC patients in Finland. We also studied the role of sex, age, stage, and university hospital district in relation to the use of HS during the pre-diagnostic phase. This information is expected to bring light on the question why CRC is often not found in its early stages.

methodsIncident CRC cases (N = 3115) concerning year 2015 were retrieved from the Finnish Cancer Registry and linked with data from the Finnish Institute for Health and Welfare on primary or specialised care outpatient visits or inpatient episodes over one year prior to CRC diagnosis. We modelled the average number of HS events per patient using Poisson regression model with log-link. Change points for monthly HS event rates and 95% CIs one year before diagnosis were evaluated using Poisson broken line regression models.

resultsAround 10% of patients diagnosed in 2015 had no events prior to cancer leaving 2816 CRCs in the study. Of all pre-diagnostic events (N = 23268), 86% were outpatient events and 14% inpatient episodes. More than half of the inpatient episodes (65%) started as urgent admissions. The use of HS started to increase 3-4 months before diagnosis. The average number of pre-diagnostic HS events per patient varied by sex, age, stage and university hospital district. Overall, men had more events per patient than women and older patients had more events than younger patients.

conclusionsThe amount of inpatient episodes starting as urgent admissions indicate potential bottlenecks in the access to health services. An increase in service use only 3-4 months prior to diagnosis reflects a need for advice both for health care professionals and the general population in recognising symptoms of CRC.

Indexed as

Colorectal NeoplasmsHealth ServicesFemaleFinlandHospitalizationHumansMaleColorectal neoplasmsCritical pathwaysHealth care utilizationHealth services researchHospitals, specialPrimary health care

Identifiers

PMID36959641
PMCPMC10035279

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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.