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

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...

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Bibliographic Details
Published in:British journal of cancer Vol. 112; no. Suppl 1; pp. S92 - S107
Main Authors: Neal, R D, Tharmanathan, P, France, B, Din, N U, Cotton, S, Fallon-Ferguson, J, Hamilton, W, Hendry, A, Hendry, M, Lewis, R, Macleod, U, Mitchell, E D, Pickett, M, Rai, T, Shaw, K, Stuart, N, Tørring, M L, Wilkinson, C, Williams, B, Williams, N, Emery, J
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 31.03.2015
Nature Publishing Group
Subjects:
692/308/409
692/699/67/1059
692/700/139
Biomedical and Life Sciences
Biomedicine
Cancer Research
Delayed Diagnosis - statistics & numerical data
Drug Resistance
Epidemiology
full-paper
Humans
Molecular Medicine
Neoplasms - diagnosis
Neoplasms - therapy
Oncology
Prognosis
Time-to-Treatment - statistics & numerical data
diagnosis
stage
systematic review
delays
survival
ISSN:0007-0920, 1532-1827, 1532-1827
Online Access:Get full text
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Summary: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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ISSN:0007-0920
1532-1827
1532-1827
DOI:10.1038/bjc.2015.48