The impact of treatment delay on survival, and the significance of the diverse factors involved, have yet to be determined. Moreover, it has been reported that delay is often attributable to tumour factors such as clinical stage and location, and not only to the health system, such as hospital admission procedures.
While some studies indicate that treatment delay negatively affects the prognosis of patients with cancer, particularly CRC, others have found no such association. In fact, delays in initiating treatment are the leading cause of malpractice complaints. Although delays attributable to the health system constitute a small proportion of the biological life of a tumour, noticeable hospital delay (from first hospital visit to diagnosis or from diagnosis to treatment) may provoke stress and decrease the patient’s quality of life. As a result of population aging, together with diagnostic and therapeutic advances, the number of cancer patients has increased significantly, and this situation is placing great pressure on the cancer care system, reflecting the growing importance of this group of diseases as a public health problem.Įarly diagnosis of cancer and hence early treatment is a fundamental objective in cancer care procedures. In Europe, five-year survival rates are 44-64%, and in Spain the EUROCARE-4 project calculated a survival rate of 61.5%. It is the second most prevalent malignancy worldwide, and is also second in incidence and mortality in most developed countries. Greater attention should be paid by the healthcare provider to social groups with less formal education, in order to optimise treatment attention.Ĭolorectal cancer (CRC) is a major public health problem, with major impact on morbidity and mortality. We conclude that treatment delay in CRC patients is affected not only by clinicopathological factors, but also by sociocultural ones. Among rectal cancer patients, the corresponding factors were primary school education and being asymptomatic. Independent predictor variables of DFT in colon cancer patients were a low level of education, small tumour, ex-smoker, asymptomatic at diagnosis and following the application of screening.
DFT is defined as time elapsed between diagnosis and first treatment exceeding 30 days.Įxcessive treatment delay was recorded in 65.5% of the cases, and was more prevalent among rectal cancer patients. The study population was recruited between June 2010 and December 2012.
Received: Accepted: NovemPublished: November 24, 2016Ī prospective study was performed of patients diagnosed with colorectal cancer (CRC), distinguishing between colonic and rectal location, to determine the factors that may provoke a delay in the first treatment (DFT) provided.Ģ749 patients diagnosed with CRC were studied. Keywords: colorectal, cancer, delay, treatment, education Irene Zarcos-Pedrinaci 1, 11, Alberto Fernández-López 2, Teresa Téllez 1, 11, Francisco Rivas-Ruiz 1, 11, Antonio Rueda A 3, 11, María Manuela Morales Suarez-Varela 4, Eduardo Briones 5, Marisa Baré 6, 11, Antonio Escobar 7, 11, Cristina Sarasqueta 8, 11, Nerea Fernández de Larrea 9, 11, Urko Aguirre 10, 11, José María Quintana 10, 11, Maximino Redondo 1, 11 and On Behalf of the CARESS-CCR Study GroupġResearch Unit, Agencia Sanitaria Costa del Sol, Marbella, SpainĢServicio de Cirugía, Agencia Sanitaria Costa del Sol, Marbella, SpainģServicio de Oncología Médica, Agencia Sanitaria Costa del Sol, Marbella, SpainĤUnit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, CIBER-Epidemiology and Public Health (CIBERESP), Valencia, SpainĥPublic Health Unit, Distrito Sanitario Sevilla, Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Madrid, SpainĦClinical Epidemiology and Cancer Screening, Corporació Sanitària Parc Taulí, Sabadell, SpainħResearch Unit, Hospital Universitario Basurto, Bilbao, SpainĨResearch Unit, Donostia University Hospital, San Sebastián, SpainĩArea of Environmental Epidemiology and Cancer, National Epidemiology Centre, Instituto de Salud Carlos III, Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spainġ0Research Unit, Hospital Galdakao-Usansolo, Galdakao, Spainġ1Red de Investigación en Servicios de Salud en Enfermedades Crónicas – REDISSEC, Spain
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