Why So Late?!--delay in Treatment of Colorectal Cancer is Socially Determined

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2010 Jun 29

PMID 20582599

Citations 7

Authors

Mike Ralf Langenbach

Stefan Sauerland

Karl-Wilhelm Krobel

Hubert Zirngibl

Affiliations

Soon will be listed here.

Abstract

Purpose: The interval between symptom onset and therapy in patients with colorectal cancer was studied.

Methods: One hundred twenty three patients with colorectal cancer were included. Demography data, symptoms, consultations, and tumour stage were obtained by standardized questionnaires. Risk factors for delayed treatment were analysed.

Results: Eighty six patients suffered from colonic cancer. The total time between the first symptoms and therapy ranged from 13 to 442 days (mean, 148). Delay of surgical therapy was responsible for significantly higher tumour grades. Delayed start of therapy was found to be correlated to the type of cancer, socioeconomic status, marital status, and quality of first consultation (univariate analysis). On multivariate analyses, type of cancer, marital and socioeconomic status remained significantly associated with delayed treatment (all p values ≤ 0.001, r(2) = 0.50).

Conclusions: The delay in treatment of colorectal cancer depends on socioeconomic status and family background. Achieving equity in colorectal cancer detection may require consideration of high-risk subgroups.

Citing Articles

Inequalities in treatment among patients with colon and rectal cancer: a multistate survival model using data from England national cancer registry 2012-2016.

Ling S, Luque Fernandez M, Quaresma M, Belot A, Rachet B Br J Cancer. 2023; 130(1):88-98.

PMID: 37741899 PMC: 10781675. DOI: 10.1038/s41416-023-02440-6.

Conflicting Guidelines: A Systematic Review on the Proper Interval for Colorectal Cancer Treatment.

Molenaar C, Janssen L, van der Peet D, Winter D, Roumen R, Slooter G World J Surg. 2021; 45(7):2235-2250.

PMID: 33813632 DOI: 10.1007/s00268-021-06075-7.

Pre-to-post diagnosis weight trajectories in colorectal cancer patients with non-metastatic disease.

van Zutphen M, Geelen A, Boshuizen H, Winkels R, Geijsen A, Wesselink E Support Care Cancer. 2018; 27(4):1541-1549.

PMID: 30484014 PMC: 6394719. DOI: 10.1007/s00520-018-4560-z.

Extensive screening of microRNA populations identifies hsa-miR-375 and hsa-miR-133a-3p as selective markers for human rectal and colon cancer.

Weber D, Amar L, Godde D, Prinz C Oncotarget. 2018; 9(43):27256-27267.

PMID: 29930763 PMC: 6007480. DOI: 10.18632/oncotarget.25535.

Socioeconomic disparities affect survival in malignant ovarian germ cell tumors in AYA population.

Bownes L, Stafman L, Maizlin I, Dellinger M, Gow K, Goldin A J Surg Res. 2017; 222:180-186.e3.

PMID: 28988685 PMC: 5742061. DOI: 10.1016/j.jss.2017.09.013.

References

Harris G, Simson J . Causes of late diagnosis in cases of colorectal cancer seen in a district general hospital over a 2-year period. Ann R Coll Surg Engl. 1998; 80(4):246-8. PMC: 2503090. View

Khattak I, Eardley N, Rooney P . Colorectal cancer--a prospective evaluation of symptom duration and GP referral patterns in an inner city teaching hospital. Colorectal Dis. 2006; 8(6):518-21. DOI: 10.1111/j.1463-1318.2006.00967.x. View

Steinert R, Marusch F, Koch A, Ptok H, Reymond M, Gastinger I . [Options for quality improvement in the treatment of rectum carcinoma]. Zentralbl Chir. 2005; 130(5):387-92. DOI: 10.1055/s-2005-836892. View

Graffner H, Olsson S . Patient's and doctor's delay in carcinoma of the colon and rectum. J Surg Oncol. 1986; 31(3):188-90. DOI: 10.1002/jso.2930310311. View

Arbman G, Nilsson E, Sjodahl R . A short diagnostic delay is more important for rectal cancer than for colonic cancer. Eur J Surg. 1996; 162(11):899-904. View

Schiffmann L, Ozcan S, Schwarz F, Lange J, Prall F, Klar E . Colorectal cancer in the elderly: surgical treatment and long-term survival. Int J Colorectal Dis. 2008; 23(6):601-10. DOI: 10.1007/s00384-008-0457-5. View

Schoppmeyer K, Spieker H, Mossner J . Failure of screening or failure to screen? The screening behavior of patients with colorectal cancer in the Leipzig area. Dtsch Arztebl Int. 2009; 106(12):195-201. PMC: 2680578. DOI: 10.3238/arztebl.2009.0195. View

Taylor C, Schultz S, Paszat L, Bondy S, Rabeneck L . Prevalence of screening in patients newly diagnosed with colorectal cancer in Ontario. Can J Gastroenterol. 2007; 21(12):805-8. PMC: 2658572. DOI: 10.1155/2007/230420. View

Langenbach M, Schmidt J, Neumann J, Zirngibl H . Delay in treatment of colorectal cancer: multifactorial problem. World J Surg. 2003; 27(3):304-8. DOI: 10.1007/s00268-002-6678-9. View

10.

Korsgaard M, Pedersen L, Sorensen H, Laurberg S . Reported symptoms, diagnostic delay and stage of colorectal cancer: a population-based study in Denmark. Colorectal Dis. 2006; 8(8):688-95. DOI: 10.1111/j.1463-1318.2006.01014.x. View

11.

Holliday H, Hardcastle J . Delay in diagnosis and treatment of symptomatic colorectal cancer. Lancet. 1979; 1(8111):309-11. DOI: 10.1016/s0140-6736(79)90718-9. View

12.

Frederiksen B, Osler M, Harling H, Jorgensen T . Social inequalities in stage at diagnosis of rectal but not in colonic cancer: a nationwide study. Br J Cancer. 2008; 98(3):668-73. PMC: 2243153. DOI: 10.1038/sj.bjc.6604215. View

13.

Turunen M, PELTOKALLIO P . Delay in the diagnosis of colorectal cancer. Ann Chir Gynaecol. 1982; 71(5):277-82. View

14.

Robinson E, Mohilever J, Zidan J, Sapir D . Colorectal cancer: incidence, delay in diagnosis and stage of disease. Eur J Cancer Clin Oncol. 1986; 22(2):157-61. DOI: 10.1016/0277-5379(86)90025-8. View

15.

Carter S, Winslet M . Delay in the presentation of colorectal carcinoma: a review of causation. Int J Colorectal Dis. 1998; 13(1):27-31. DOI: 10.1007/s003840050127. View

16.

Gomez-Dominguez E, Trapero-Marugan M, del Pozo A, Cantero J, Gisbert J, Mate J . The colorectal carcinoma prognosis factors. Significance of diagnosis delay. Rev Esp Enferm Dig. 2006; 98(5):322-9. DOI: 10.4321/s1130-01082006000500002. View

17.

Roncoroni L, Pietra N, Violi V, Sarli L, Choua O, Peracchia A . Delay in the diagnosis and outcome of colorectal cancer: a prospective study. Eur J Surg Oncol. 1999; 25(2):173-8. DOI: 10.1053/ejso.1998.0622. View

18.

Brenner H, Hoffmeister M, Brenner G, Altenhofen L, Haug U . Expected reduction of colorectal cancer incidence within 8 years after introduction of the German screening colonoscopy programme: estimates based on 1,875,708 screening colonoscopies. Eur J Cancer. 2009; 45(11):2027-33. DOI: 10.1016/j.ejca.2009.02.017. View

19.

Davies E, Van Der Molen B, Cranston A . Using clinical audit, qualitative data from patients and feedback from general practitioners to decrease delay in the referral of suspected colorectal cancer. J Eval Clin Pract. 2007; 13(2):310-7. DOI: 10.1111/j.1365-2753.2006.00820.x. View

20.

McArdle C, Hole D . Outcome following surgery for colorectal cancer: analysis by hospital after adjustment for case-mix and deprivation. Br J Cancer. 2002; 86(3):331-5. PMC: 2375219. DOI: 10.1038/sj.bjc.6600120. View