Symptom-to-diagnosis interval and survival in cancers of the digestive tract

Esteve Fernandez, Miquel Porta, Núria Malats, Josep Belloc, Manuel Gallén

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44 Citations (Scopus)

Abstract

The objective was to identify the main correlates of the symptom-to-diagnosis interval (SDI) and to analyze their influence upon the survival in patients with cancers of the digestive tract. Two hundred forty-eight symptomatic patients with cancer of the esophagus (N = 31), stomach (N = 70), colon (N = 84), and rectum (N = 66) were interviewed and prospectively followed (median follow-up of 77 months). Cox's regression was used to assess the relative risk (RR) of death according to SDI. The median SDI was about 4 months, with nonsignificant differences by sex, age, social class, family history of cancer, or tumor site. The RR of death varied significantly by age (P = 0.012), tumor site (P < 0.01), tumor stage (P < 0.01), and type of hospital admission (P < 0.01). After adjustment for known and potential predictors of survival and as compared to an SDI < 2.5 months, the RR of death was 0.89 (95% CI: 0.61-1.32) for an SDI of 2.5-6 months, 0.78 (95% CI: 0.49-1.26) for SDI > 6-12 months, and 0.81 (95% CI: 0.44-1.49) for SDI > 12 months. These results do not imply that specific actions to hasten diagnosis must of necessity be ineffective, but underscore what a challenging task the secondary prevention of cancer remains.
Original languageEnglish
Pages (from-to)2434-2440
JournalDigestive Diseases and Sciences
Volume47
DOIs
Publication statusPublished - 1 Nov 2002

Keywords

  • Delay
  • Diagnosis
  • Gastrointestinal neoplasms
  • Healthcare-seeking behavior
  • Prognosis
  • Survival
  • Symptom duration

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