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The relative length of the patient and the primary care interval in patients with 28 common and rarer cancers.

Lyratzopoulos G, Saunders CL, Abel GA, McPhail S, Neal RD, Wardle J, Rubin GP - Br. J. Cancer (2015)

Bottom Line: Appreciating variation in the length of pre- or post-presentation diagnostic intervals can help prioritise early diagnosis interventions with either a community or a primary care focus.Laryngeal and oropharyngeal cancers had the longest median patient intervals, whereas renal and bladder cancer had the shortest (34.5 and 30 compared with 3 and 2 days, respectively).Multiple myeloma and gallbladder cancer had the longest median primary care intervals, and melanoma and breast cancer had the shortest (20.5 and 20 compared with 0 and 0 days, respectively).

View Article: PubMed Central - PubMed

Affiliation: 1] Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK [2] Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.

ABSTRACT

Background: Appreciating variation in the length of pre- or post-presentation diagnostic intervals can help prioritise early diagnosis interventions with either a community or a primary care focus.

Methods: We analysed data from the first English National Audit of Cancer Diagnosis in Primary Care on 10 953 patients with any of 28 cancers. We calculated summary statistics for the length of the patient and the primary care interval and their ratio, by cancer site.

Results: Interval lengths varied greatly by cancer. Laryngeal and oropharyngeal cancers had the longest median patient intervals, whereas renal and bladder cancer had the shortest (34.5 and 30 compared with 3 and 2 days, respectively). Multiple myeloma and gallbladder cancer had the longest median primary care intervals, and melanoma and breast cancer had the shortest (20.5 and 20 compared with 0 and 0 days, respectively). Mean patient intervals were longer than primary care intervals for most (18 of 28) cancers, and notably so (two- to five-fold greater) for 10 cancers (breast, melanoma, testicular, vulval, cervical, endometrial, oropharyngeal, laryngeal, ovarian and thyroid).

Conclusions: The findings support the continuing development and evaluation of public health interventions aimed at shortening patient intervals, particularly for cancers with long patient interval and/or high patient interval over primary care interval ratio.

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Related in: MedlinePlus

Visual summary of length of the patient, the primary care and the pre-referral intervals by cancer. Bar length represents the size of the interquartile interval, with median values depicted by a vertical line. Cancers are ordered in ascending order of median patient interval. Note that median patient intervals tend to be longer than primary care intervals for most cancers, and very short primary care intervals are seen for cancers such as breast, vulval and melanoma.
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fig1: Visual summary of length of the patient, the primary care and the pre-referral intervals by cancer. Bar length represents the size of the interquartile interval, with median values depicted by a vertical line. Cancers are ordered in ascending order of median patient interval. Note that median patient intervals tend to be longer than primary care intervals for most cancers, and very short primary care intervals are seen for cancers such as breast, vulval and melanoma.

Mentions: Mean and median patient intervals were longer than mean and median primary care intervals for most cancers (18 out of 28 and 20 out of 28, respectively; Table 1). In particular, the mean patient interval was approximately five-fold greater than the mean primary care interval for breast cancer, four-fold greater for melanoma and testicular cancer, three-fold greater for vulval and cervical cancer and two-fold greater for endometrial, oropharyngeal, laryngeal, ovarian and thyroid cancers (Table 2). Figures 1 and 2 pictorially summarise the patient and the primary care interval by cancer site.


The relative length of the patient and the primary care interval in patients with 28 common and rarer cancers.

Lyratzopoulos G, Saunders CL, Abel GA, McPhail S, Neal RD, Wardle J, Rubin GP - Br. J. Cancer (2015)

Visual summary of length of the patient, the primary care and the pre-referral intervals by cancer. Bar length represents the size of the interquartile interval, with median values depicted by a vertical line. Cancers are ordered in ascending order of median patient interval. Note that median patient intervals tend to be longer than primary care intervals for most cancers, and very short primary care intervals are seen for cancers such as breast, vulval and melanoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385974&req=5

fig1: Visual summary of length of the patient, the primary care and the pre-referral intervals by cancer. Bar length represents the size of the interquartile interval, with median values depicted by a vertical line. Cancers are ordered in ascending order of median patient interval. Note that median patient intervals tend to be longer than primary care intervals for most cancers, and very short primary care intervals are seen for cancers such as breast, vulval and melanoma.
Mentions: Mean and median patient intervals were longer than mean and median primary care intervals for most cancers (18 out of 28 and 20 out of 28, respectively; Table 1). In particular, the mean patient interval was approximately five-fold greater than the mean primary care interval for breast cancer, four-fold greater for melanoma and testicular cancer, three-fold greater for vulval and cervical cancer and two-fold greater for endometrial, oropharyngeal, laryngeal, ovarian and thyroid cancers (Table 2). Figures 1 and 2 pictorially summarise the patient and the primary care interval by cancer site.

Bottom Line: Appreciating variation in the length of pre- or post-presentation diagnostic intervals can help prioritise early diagnosis interventions with either a community or a primary care focus.Laryngeal and oropharyngeal cancers had the longest median patient intervals, whereas renal and bladder cancer had the shortest (34.5 and 30 compared with 3 and 2 days, respectively).Multiple myeloma and gallbladder cancer had the longest median primary care intervals, and melanoma and breast cancer had the shortest (20.5 and 20 compared with 0 and 0 days, respectively).

View Article: PubMed Central - PubMed

Affiliation: 1] Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK [2] Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.

ABSTRACT

Background: Appreciating variation in the length of pre- or post-presentation diagnostic intervals can help prioritise early diagnosis interventions with either a community or a primary care focus.

Methods: We analysed data from the first English National Audit of Cancer Diagnosis in Primary Care on 10 953 patients with any of 28 cancers. We calculated summary statistics for the length of the patient and the primary care interval and their ratio, by cancer site.

Results: Interval lengths varied greatly by cancer. Laryngeal and oropharyngeal cancers had the longest median patient intervals, whereas renal and bladder cancer had the shortest (34.5 and 30 compared with 3 and 2 days, respectively). Multiple myeloma and gallbladder cancer had the longest median primary care intervals, and melanoma and breast cancer had the shortest (20.5 and 20 compared with 0 and 0 days, respectively). Mean patient intervals were longer than primary care intervals for most (18 of 28) cancers, and notably so (two- to five-fold greater) for 10 cancers (breast, melanoma, testicular, vulval, cervical, endometrial, oropharyngeal, laryngeal, ovarian and thyroid).

Conclusions: The findings support the continuing development and evaluation of public health interventions aimed at shortening patient intervals, particularly for cancers with long patient interval and/or high patient interval over primary care interval ratio.

Show MeSH
Related in: MedlinePlus