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Br J Cancer. 2015 Mar 31;112 Suppl 1:S92-107. doi: 10.1038/bjc.2015.48.

Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes? Systematic review.

Author information

1
North Wales Centre for Primary Care Research, Bangor University, Bangor LL13 7YP, UK.
2
Department of Health Sciences, University of York, York, YO10 5DD, UK.
3
Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital, Wrexham LL13 7TD, UK.
4
Primary Care Collaborative Cancer Clinical Trials Group, School of Primary, Aboriginal, and Rural Healthcare, University of Western Australia, M706, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
5
University of Exeter Medical School, Exeter EX1 2LU, UK.
6
Centre for Health and Population studies, Hull York Medical School, University of Hull, Hull HU6 7RX, UK.
7
Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK.
8
North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor LL57 2PZ, UK.
9
School of Medical Sciences, Bangor University, Bangor, LL57 2AS UK.
10
Research Unit for General Practice, Aarhus University, Bartholins Alle 2, Aarhus DK-8000, Denmark.
11
1] North Wales Centre for Primary Care Research, Bangor University, Bangor LL13 7YP, UK [2] North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor LL57 2PZ, UK.
12
1] Primary Care Collaborative Cancer Clinical Trials Group, School of Primary, Aboriginal, and Rural Healthcare, University of Western Australia, M706, 35 Stirling Highway, Crawley, Western Australia 6009, Australia [2] General Practice & Primary Care Academic Centre, University of Melbourne, 200 Berkeley Street, Melbourne, Victoria 3053, Australia.

Abstract

BACKGROUND:

It is unclear whether more timely cancer diagnosis brings favourable outcomes, with much of the previous evidence, in some cancers, being equivocal. We set out to determine whether there is an association between time to diagnosis, treatment and clinical outcomes, across all cancers for symptomatic presentations.

METHODS:

Systematic review of the literature and narrative synthesis.

RESULTS:

We included 177 articles reporting 209 studies. These studies varied in study design, the time intervals assessed and the outcomes reported. Study quality was variable, with a small number of higher-quality studies. Heterogeneity precluded definitive findings. The cancers with more reports of an association between shorter times to diagnosis and more favourable outcomes were breast, colorectal, head and neck, testicular and melanoma.

CONCLUSIONS:

This is the first review encompassing many cancer types, and we have demonstrated those cancers in which more evidence of an association between shorter times to diagnosis and more favourable outcomes exists, and where it is lacking. We believe that it is reasonable to assume that efforts to expedite the diagnosis of symptomatic cancer are likely to have benefits for patients in terms of improved survival, earlier-stage diagnosis and improved quality of life, although these benefits vary between cancers.

PMID:
25734382
PMCID:
PMC4385982
DOI:
10.1038/bjc.2015.48
[Indexed for MEDLINE]
Free PMC Article

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