Relationship between time from symptom's onset to diagnosis and prognosis in patients with symptomatic colorectal cancer

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• dc.contributor.author Esteva, Magdalena
• dc.contributor.author Leiva, Alfonso
• dc.contributor.author Ramos-Monserrat, María
• dc.contributor.author Espí, Alejandro
• dc.contributor.author González Luján, Luis
• dc.contributor.author Macià Guilà, Francesc Assís
• dc.contributor.author Murta-Nascimento, Cristiane
• dc.contributor.author Sánchez-Calavera,María A.
• dc.contributor.author Magallón, Rosa
• dc.contributor.author Balboa-Barreiro, Vanesa
• dc.contributor.author Seoane-Pillado, Teresa
• dc.contributor.author Pertega-Díaz, Sonia
• dc.date.accessioned 2023-01-18T07:31:00Z
• dc.date.available 2023-01-18T07:31:00Z
• dc.date.issued 2022
• dc.description.abstract Background: controversy exists regarding the relationship of the outcome of patients with colorectal cancer (CRC) with the time from symptom onset to diagnosis. The aim of this study is to investigate this association, with the assumption that this relationship was nonlinear and with adjustment for multiple confounders, such as tumor grade, symptoms, or admission to an emergency department. Methods: this multicenter study with prospective follow-up was performed in five regions of Spain from 2010 to 2012. Symptomatic cases of incident CRC from a previous study were examined. At the time of diagnosis, each patient was interviewed, and the associated hospital and clinical records were reviewed. During follow-up, the clinical records were reviewed again to assess survival. Cox survival analysis with a restricted cubic spline was used to model overall and CRC-specific survival, with adjustment for variables related to the patient, health service, and tumor. Results: a total of 795 patients had symptomatic CRC and 769 of them had complete data on diagnostic delay and survival. Univariate analysis indicated a lower HR for death in patients who had diagnostic intervals less than 4.2 months. However, after adjustment for variables related to the patient, tumor, and utilized health service, there was no relationship of the diagnostic delay with survival of patients with colon and rectal cancer, colon cancer alone, or rectal cancer alone. Cubic spline analysis indicated an inverse association of the diagnostic delay with 5-year survival. However, this association was not statistically significant. Conclusions: our results indicated that the duration of diagnostic delay had no significant effect on the outcome of patients with CRC. We suggest that the most important determinant of the duration of diagnostic delay is the biological profile of the tumor. However, it remains the responsibility of community health centers and authorities to minimize diagnostic delays in patients with CRC and to implement initiatives that improve early diagnosis and provide better outcomes.
• dc.format.mimetype application/pdf
• dc.identifier.citation Esteva M, Leiva A, Ramos-Monserrat M, Espí A, González-Luján L, Macià F, et al. Relationship between time from symptom's onset to diagnosis and prognosis in patients with symptomatic colorectal cancer. BMC Cancer. 2022 Aug 22; 22(1): 910. DOI: 10.1186/s12885-022-09990-7
• dc.identifier.doi http://dx.doi.org/10.1186/s12885-022-09990-7
• dc.identifier.issn 1471-2407
• dc.identifier.uri http://hdl.handle.net/10230/55317
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.rights Copyright © Esteva M, Leiva A, Ramos-Monserrat M, Espí A, González-Luján L, Macià F, et al. 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Cancer-specific mortality
• dc.subject.keyword Colorectal neoplasm
• dc.subject.keyword Delayed diagnosis
• dc.subject.keyword Prognosis
• dc.subject.keyword Time factors
• dc.title Relationship between time from symptom's onset to diagnosis and prognosis in patients with symptomatic colorectal cancer
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion