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Symptom-to-Diagnosis Interval and Survival in Cancers of the Digestive Tract

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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.

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Authors and Affiliations

  1. Institut Català d'Oncologia, L'Hospitalet, Barcelona, Spain

    Esteve Fernandez

  2. Universitat de Barcelona, Barcelona, Spain

    Esteve Fernandez

  3. Universitat Autònoma de Barcelona, Barcelona, Spain

    Miquel Porta

  4. Institut Municipal d'Investigació Mèdica, Barcelona, Spain

    Núria Malats

  5. Univesitat Pompeu Fabra, Barcelona, Spain

    Núria Malats

  6. Department of Gastroenterology, Hospital del Mar, Barcelona, Spain

    Josep Belloc

  7. Department of Oncology, Hospital del Mar, Barcelona, Spain

    Manuel Gallén

Authors
  1. Esteve Fernandez
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  2. Miquel Porta
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  3. Núria Malats
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  4. Josep Belloc
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  5. Manuel Gallén
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Fernandez, E., Porta, M., Malats, N. et al. Symptom-to-Diagnosis Interval and Survival in Cancers of the Digestive Tract. Dig Dis Sci 47, 2434–2440 (2002). https://doi.org/10.1023/A:1020535304670

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