Question on Database Studies on Comorbidities and Delayed Cancer Dx

Jason Maude Jason.Maude at ISABELHEALTHCARE.COM
Wed Apr 23 16:56:23 UTC 2014


Not sure if this covers exactly what you want but a very interesting study on 'diagnostic intervals' in cancer diagnoses was published last year which used the large UK general practice database.
http://www.nature.com/bjc/journal/v110/n3/full/bjc2013791a.html

This type of research is very useful as it starts to tell us how long the diagnosis should take and therefore establish whether a diagnosis was delayed and by how much.




Jason Maude
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890
www.isabelhealthcare.com<http://www.isabelhealthcare.com/>

From: Alexander Cole <acole16 at JHMI.EDU<mailto:acole16 at JHMI.EDU>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, Alexander Cole <acole16 at JHMI.EDU<mailto:acole16 at JHMI.EDU>>
Date: Wednesday, 23 April 2014 10:38
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: [IMPROVEDX] Question on Database Studies on Comorbidities and Delayed Cancer Dx

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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