Do diagnostic and treatment delays for colorectal cancer increase risk of death?
Background: Using 1998-2005 SEER-Medicare data, we examined the effect of diagnostic and treatment delays on all-cause and colorectal cancer (CRC)-specific death among US adults aged ≥ 66 years with invasive colon or rectal cancer. We hypothesized that longer delays would be associated with a greate...
| Publicado en: | Cancer Causes & Control Vol. 24; no. 5; pp. 961 - 978 |
|---|---|
| Autores principales: | , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
May2013
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104071118&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104071118 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09575243 ODX jtl: Cancer Causes & Control issn: 09575243 maglogo: N pubinfo: dt: May2013 vid: 24 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104071118 NLM23446843 2012090067 10.1007/s10552-013-0172-6 NLM23446843 PMC3708300 104071118 ppf: 961 ppct: 17 formats: fmt: @attributes: type: P tig: atl: Do diagnostic and treatment delays for colorectal cancer increase risk of death? aug: au: Pruitt, Sandi L Harzke, Amy Jo Davidson, Nicholas O Schootman, Mario affil: Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd E1.410D, Dallas, TX, 75390-9169, USA, sandi.pruitt@utsouthwestern.edu. sug: subj: Colorectal Neoplasms Diagnosis Colorectal Neoplasms Therapy Aged Aged, 80 and Over Colon Pathology Colorectal Neoplasms Mortality Early Detection of Cancer Female Human Logistic Regression Male Risk Assessment Registries, Disease Time Factors Aged: 65+ years Aged, 80 & over Female Male ab: Background: Using 1998-2005 SEER-Medicare data, we examined the effect of diagnostic and treatment delays on all-cause and colorectal cancer (CRC)-specific death among US adults aged ≥ 66 years with invasive colon or rectal cancer. We hypothesized that longer delays would be associated with a greater risk of death.Methods: We defined diagnostic and treatment delays, respectively, as days between (1) initial medical consult for CRC symptoms and pathologically confirmed diagnosis (maximum: 365 days) and (2) pathologically confirmed diagnosis and treatment (maximum: 120 days). Cases (CRC deaths) and controls (deaths due to other causes or censored) were matched on survival time. Logistic regression analyses adjusted for sociodemographic, tumor, and treatment factors.Results: Median diagnostic delays were 60 (colon) and 40 (rectal) days and treatment delays were 13 (colon) and 16 (rectal) days in 10,663 patients. Colon cancer patients with the longest diagnostic delays (8-12 months vs. 14-59 days) had higher odds of all-cause (aOR: 1.31 CI: 1.08-1.58), but not CRC-specific death. Colon cancer patients with the shortest treatment delays (<1 vs. 1-2 weeks) had higher odds of all-cause (aOR: 1.23 CI: 1.01-1.49), but not CRC-specific death. Among rectal cancer patients, delays were not associated with risk of all-cause or CRC-specific death.Conclusions: Longer delays of up to 1 year after symptom onset and 120 days for treatment did not increase odds of CRC-specific death. There may be little clinical benefit in detecting and treating existing symptomatic disease earlier. Screening prior to symptom onset must remain the primary goal to reduce CRC incidence, morbidity, and mortality. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|