TY - JOUR
T1 - Diagnostic routes and time intervals for patients with colorectal cancer in 10 international jurisdictions; Findings from a cross-sectional study from the International Cancer Benchmarking Partnership (ICBP)
AU - Weller, David
AU - Menon, Usha
AU - Zalounina Falborg, Alina
AU - Jensen, Henry
AU - Barisic, Andriana
AU - Knudsen, Anne Kari
AU - Bergin, Rebecca J.
AU - Brewster, David H.
AU - Cairnduff, Victoria
AU - Gavin, Anna T.
AU - Grunfeld, Eva
AU - Harland, Elizabeth
AU - Lambe, Mats
AU - Law, Rebecca Jane
AU - Lin, Yulan
AU - Malmberg, Martin
AU - Turner, Donna
AU - Neal, Richard D.
AU - White, Victoria
AU - Harrison, Samantha
AU - Reguilon, Irene
AU - Vedsted, Peter
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Objective International differences in colorectal cancer (CRC) survival and stage at diagnosis have been reported previously. They may be linked to differences in time intervals and routes to diagnosis. The International Cancer Benchmarking Partnership Module 4 (ICBP M4) reports the first international comparison of routes to diagnosis for patients with CRC and the time intervals from symptom onset until the start of treatment. Data came from patients in 10 jurisdictions across six countries (Canada, the UK, Norway, Sweden, Denmark and Australia). Design Patients with CRC were identified via cancer registries. Data on symptomatic and screened patients were collected; questionnaire data from patients' primary care physicians and specialists, as well as information from treatment records or databases, supplemented patient data from the questionnaires. Routes to diagnosis and the key time intervals were described, as were between-jurisdiction differences in time intervals, using quantile regression. Participants A total of 14 664 eligible patients with CRC diagnosed between 2013 and 2015 were identified, of which 2866 were included in the analyses. Primary and secondary outcome measures Interval lengths in days (primary), reported patient symptoms (secondary). Results The main route to diagnosis for patients was symptomatic presentation and the most commonly reported symptom was 'bleeding/blood in stool'. The median intervals between jurisdictions ranged from: 21 to 49 days (patient); 0 to 12 days (primary care); 27 to 76 days (diagnostic); and 77 to 168 days (total, from first symptom to treatment start). Including screen-detected cases did not significantly alter the overall results. Conclusion ICBP M4 demonstrates important differences in time intervals between 10 jurisdictions internationally. The differences may justify efforts to reduce intervals in some jurisdictions.
AB - Objective International differences in colorectal cancer (CRC) survival and stage at diagnosis have been reported previously. They may be linked to differences in time intervals and routes to diagnosis. The International Cancer Benchmarking Partnership Module 4 (ICBP M4) reports the first international comparison of routes to diagnosis for patients with CRC and the time intervals from symptom onset until the start of treatment. Data came from patients in 10 jurisdictions across six countries (Canada, the UK, Norway, Sweden, Denmark and Australia). Design Patients with CRC were identified via cancer registries. Data on symptomatic and screened patients were collected; questionnaire data from patients' primary care physicians and specialists, as well as information from treatment records or databases, supplemented patient data from the questionnaires. Routes to diagnosis and the key time intervals were described, as were between-jurisdiction differences in time intervals, using quantile regression. Participants A total of 14 664 eligible patients with CRC diagnosed between 2013 and 2015 were identified, of which 2866 were included in the analyses. Primary and secondary outcome measures Interval lengths in days (primary), reported patient symptoms (secondary). Results The main route to diagnosis for patients was symptomatic presentation and the most commonly reported symptom was 'bleeding/blood in stool'. The median intervals between jurisdictions ranged from: 21 to 49 days (patient); 0 to 12 days (primary care); 27 to 76 days (diagnostic); and 77 to 168 days (total, from first symptom to treatment start). Including screen-detected cases did not significantly alter the overall results. Conclusion ICBP M4 demonstrates important differences in time intervals between 10 jurisdictions internationally. The differences may justify efforts to reduce intervals in some jurisdictions.
KW - epidemiology
KW - gastrointestinal tumours
KW - health policy
KW - international health services
KW - organisation of health services
UR - http://www.scopus.com/inward/record.url?scp=85057275037&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-023870
DO - 10.1136/bmjopen-2018-023870
M3 - Journal article
C2 - 30482749
AN - SCOPUS:85057275037
SN - 2044-6055
VL - 8
JO - BMJ Open
JF - BMJ Open
IS - 11
M1 - e023870
ER -