Systematic review of factors influencing patient and practitioner delay in diagnosis of upper gastrointestinal cancer

Campbell, N.C., Macdonald, S. , Macleod, U., Mitchell, E.D. and Weller, D. (2006) Systematic review of factors influencing patient and practitioner delay in diagnosis of upper gastrointestinal cancer. British Journal of Cancer, 94(9), pp. 1272-1280. (doi: 10.1038/sj.bjc.6603089)

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As knowledge on the causation of cancers advances and new treatments are developed, early recognition and accurate diagnosis becomes increasingly important. This review focused on identifying factors influencing patient and primary care practitioner delay for upper gastrointestinal cancer. A systematic methodology was applied, including extensive searches of the literature published from 1970 to 2003, systematic data extraction, quality assessment and narrative data synthesis. Included studies were those evaluating factors associated with the time interval between a patient first noticing a cancer symptom and presenting to primary care, between a patient first presenting to primary care and being referred to secondary care, or describing an intervention designed to reduce those intervals. Twenty-five studies were included in the review. Studies reporting delay intervals demonstrated that the patient phase of delay was greater than the practitioner phase, whilst patient-related research suggests that recognition of symptom seriousness is more important than recognition of the presence of the symptom. The main factors related to practitioner delay were misdiagnosis, application and interpretation of tests, and the confounding effect of existing disease. Greater understanding of patient factors is required, along with evaluation of interventions to ensure appropriate diagnosis, examination and investigation.

Item Type:Articles
Glasgow Author(s) Enlighten ID:MacLeod, Dr Una and Mitchell, Dr Elizabeth and Macdonald, Professor Sara
Authors: Campbell, N.C., Macdonald, S., Macleod, U., Mitchell, E.D., and Weller, D.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences
Journal Name:British Journal of Cancer
Publisher:Nature Publishing Group
ISSN (Online):1532-1827
Published Online:11 April 2006
Copyright Holders:Copyright © 2006 The Authors
First Published:First published in British Journal of Cancer 94(1):1272-1280
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
309001Factors influencing patient and primary care delay in the diagnosis of cancer: a database of existing research and its implications for...Una MacleodDepartment of Health (DOH-R&D)1217522RI HEALTH & WELLBEING