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

Neal RD, Tharmanathan P, France B, Din NU, Cotton S, Fallon-Ferguson J, Hamilton W, Hendry A, Hendry M, Lewis R, Macleod U, Mitchell ED, Pickett M, Rai T, Shaw K, Stuart N, Tørring ML, Wilkinson C, Williams B, Williams N, Emery J - Br. J. Cancer (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: North Wales Centre for Primary Care Research, Bangor University, Bangor LL13 7YP, UK.

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.

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Related in: MedlinePlus

Flow diagram. *Of those breast and colorectal cancer records published up to March 2010 (n=706) assessed for retrieval, 330 were retrieved and assessed for inclusion but were not included in the evaluation, as systematic reviews on these cancers had been recently published. The follow-up review, covering the period March 2010 to October 2013, included both breast and colorectal cancers in the qualitative synthesis.
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fig3: Flow diagram. *Of those breast and colorectal cancer records published up to March 2010 (n=706) assessed for retrieval, 330 were retrieved and assessed for inclusion but were not included in the evaluation, as systematic reviews on these cancers had been recently published. The follow-up review, covering the period March 2010 to October 2013, included both breast and colorectal cancers in the qualitative synthesis.

Mentions: The number of studies screened, assessed for eligibility, included and reasons for exclusion are shown in Figure 3. Of the 1036 records identified for full-text review, 177 articles, reporting 209 studies, met the inclusion criteria and entered the narrative synthesis. A number of the articles reported data on more than one cancer, or more than one interval.


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

Neal RD, Tharmanathan P, France B, Din NU, Cotton S, Fallon-Ferguson J, Hamilton W, Hendry A, Hendry M, Lewis R, Macleod U, Mitchell ED, Pickett M, Rai T, Shaw K, Stuart N, Tørring ML, Wilkinson C, Williams B, Williams N, Emery J - Br. J. Cancer (2015)

Flow diagram. *Of those breast and colorectal cancer records published up to March 2010 (n=706) assessed for retrieval, 330 were retrieved and assessed for inclusion but were not included in the evaluation, as systematic reviews on these cancers had been recently published. The follow-up review, covering the period March 2010 to October 2013, included both breast and colorectal cancers in the qualitative synthesis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385982&req=5

fig3: Flow diagram. *Of those breast and colorectal cancer records published up to March 2010 (n=706) assessed for retrieval, 330 were retrieved and assessed for inclusion but were not included in the evaluation, as systematic reviews on these cancers had been recently published. The follow-up review, covering the period March 2010 to October 2013, included both breast and colorectal cancers in the qualitative synthesis.
Mentions: The number of studies screened, assessed for eligibility, included and reasons for exclusion are shown in Figure 3. Of the 1036 records identified for full-text review, 177 articles, reporting 209 studies, met the inclusion criteria and entered the narrative synthesis. A number of the articles reported data on more than one cancer, or more than one interval.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: North Wales Centre for Primary Care Research, Bangor University, Bangor LL13 7YP, UK.

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.

Show MeSH
Related in: MedlinePlus