Symptom-to-diagnosis interval and survival in cancers of the digestive tract

• Published in: Digestive diseases and sciences Vol. 47; no. 11; pp. 2434 - 2440
• Main Authors: Fernandez, Esteve, Porta, Miquel, Malats, Núria, Belloc, Josep, Gallén, Manuel
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01-11-2002
• Subjects: Aged; Colonic Neoplasms - diagnosis; Colonic Neoplasms - mortality; Digestive System Neoplasms - diagnosis; Digestive System Neoplasms - mortality; Digestive System Neoplasms - pathology; Esophageal Neoplasms - diagnosis; Esophageal Neoplasms - mortality; Female; Humans; Male; Prognosis; Rectal Neoplasms - diagnosis; Rectal Neoplasms - mortality; Stomach Neoplasms - diagnosis; Stomach Neoplasms - mortality; Survival Analysis; Time Factors
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1023/A:1020535304670

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.