Abstract
Stage at diagnosis and survival from cancer vary according to where people live, suggesting some may have delays in diagnosis. The aim of this study was to determine if time from presentation to treatment was longer for colorectal and breast cancer patients living further from cancer centres, and identify other important factors in delay. Data were collected on 1097 patients with breast and 1223 with colorectal cancer in north and northeast Scotland. Women with breast cancer who lived further from cancer centres were treated more quickly than those living closer to cancer centres (P = 0.011). Multilevel modelling found that this was largely due to them receiving earlier treatment at hospitals other than cancer centres. Breast lump, change in skin contour, lymphadenopathy, more symptoms and signs, and increasing age predicted faster treatment. Screen detected cancers and private referrals were treated more quickly. For colorectal cancer, time to treatment was similar for people in rural and urban areas. Quicker treatment was associated with palpable rectal or abdominal masses, tenesmus, abdominal pain, frequent GP consultations, age between 50 and 74 years, tumours of the transverse colon, and iron medication at presentation. Delay was associated with past anxiety or depression. There was variation between general practices and treatment appeared quicker at practices with more female general practitioners.
| Original language | English |
|---|---|
| Pages (from-to) | 1479-1485 |
| Number of pages | 6 |
| Journal | British Journal of Cancer |
| Volume | 90 |
| DOIs | |
| Publication status | Published - Mar 2004 |
Keywords
- breast cancer
- colorectal cancer
- provider delay
- cohort study
- primary care
- SURVIVAL
- DIAGNOSIS
- STAGE
- DEPRIVATION
- EUROPE
Cite this
Factors influencing time from presentation to treatment of colorectal and breast cancer in urban and rural areas. / Robertson, R.; Campbell, Neil Crawford; Smith, Sarah Mary; Donnan, P. T.; Sullivan, F.; Duffy, R.; Ritchie, Lewis Duthie; Millar, David G.; Cassidy, J.; Munro, Alasdair.
In: British Journal of Cancer, Vol. 90, 03.2004, p. 1479-1485.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Factors influencing time from presentation to treatment of colorectal and breast cancer in urban and rural areas
AU - Robertson, R.
AU - Campbell, Neil Crawford
AU - Smith, Sarah Mary
AU - Donnan, P. T.
AU - Sullivan, F.
AU - Duffy, R.
AU - Ritchie, Lewis Duthie
AU - Millar, David G.
AU - Cassidy, J.
AU - Munro, Alasdair
PY - 2004/3
Y1 - 2004/3
N2 - Stage at diagnosis and survival from cancer vary according to where people live, suggesting some may have delays in diagnosis. The aim of this study was to determine if time from presentation to treatment was longer for colorectal and breast cancer patients living further from cancer centres, and identify other important factors in delay. Data were collected on 1097 patients with breast and 1223 with colorectal cancer in north and northeast Scotland. Women with breast cancer who lived further from cancer centres were treated more quickly than those living closer to cancer centres (P = 0.011). Multilevel modelling found that this was largely due to them receiving earlier treatment at hospitals other than cancer centres. Breast lump, change in skin contour, lymphadenopathy, more symptoms and signs, and increasing age predicted faster treatment. Screen detected cancers and private referrals were treated more quickly. For colorectal cancer, time to treatment was similar for people in rural and urban areas. Quicker treatment was associated with palpable rectal or abdominal masses, tenesmus, abdominal pain, frequent GP consultations, age between 50 and 74 years, tumours of the transverse colon, and iron medication at presentation. Delay was associated with past anxiety or depression. There was variation between general practices and treatment appeared quicker at practices with more female general practitioners.
AB - Stage at diagnosis and survival from cancer vary according to where people live, suggesting some may have delays in diagnosis. The aim of this study was to determine if time from presentation to treatment was longer for colorectal and breast cancer patients living further from cancer centres, and identify other important factors in delay. Data were collected on 1097 patients with breast and 1223 with colorectal cancer in north and northeast Scotland. Women with breast cancer who lived further from cancer centres were treated more quickly than those living closer to cancer centres (P = 0.011). Multilevel modelling found that this was largely due to them receiving earlier treatment at hospitals other than cancer centres. Breast lump, change in skin contour, lymphadenopathy, more symptoms and signs, and increasing age predicted faster treatment. Screen detected cancers and private referrals were treated more quickly. For colorectal cancer, time to treatment was similar for people in rural and urban areas. Quicker treatment was associated with palpable rectal or abdominal masses, tenesmus, abdominal pain, frequent GP consultations, age between 50 and 74 years, tumours of the transverse colon, and iron medication at presentation. Delay was associated with past anxiety or depression. There was variation between general practices and treatment appeared quicker at practices with more female general practitioners.
KW - breast cancer
KW - colorectal cancer
KW - provider delay
KW - cohort study
KW - primary care
KW - SURVIVAL
KW - DIAGNOSIS
KW - STAGE
KW - DEPRIVATION
KW - EUROPE
U2 - 10.1038/sj.bjc.6601753
DO - 10.1038/sj.bjc.6601753
M3 - Article
VL - 90
SP - 1479
EP - 1485
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
ER -