Question on Database Studies on Comorbidities and Delayed Cancer Dx

Alexander Cole acole16 at JHMI.EDU
Wed Apr 23 09:38:11 UTC 2014

I've been reading up on delays in cancer diagnosis and had a quick question for the researchers on this list.

We all know that some potential cancer signs/symptoms (e.g. fatigue, back pain, anemia, constipation) are quite similar to those of common, benign chronic diseases which routinely seen in primary care.  (e.g. Neal, RD Do diagnostic delays in cancer matter? British Journal of Cancer (2009) 101, S9–S12. doi:10.1038/sj.bjc.6605384)

Has anyone studied how much having a benign chronic condition might impede prompt diagnosis. For example a woman with previously diagnosed iron deficiency anemia might have a slower diagnosis of a new leukemia compared to someone who presents with a new anemia.

There have been a small number studies on this similar questions using a retrospective chart reviews and the theory seems sound. My question is if anyone knows of studies looking at something similar specifically using one of the large national databases?

Most contain information about the cancer type, date and symptoms at the time of diagnosis as well as some information about prior diagnoses and health care use (e.g. iron deficiency anemia) but I can't think of an obvious way to quantify "how much" of a delay these patients incurred compared to controls other than using very very rough proxies like stage, survival data, etc.

Does anyone out there have any ideas?

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