Knowledge on the causation of cancers advances and new treatments are developing.
Subsequently, early recognition and accurate diagnosis becomes increasingly important.
Dr Liz Mitchell and colleagues from Scotland identified 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.
The research team systematically extracted data, undertook quality assessment, and narrative data synthesis.
The team included studies that evaluated factors associated with the time interval between a patient first noticing a cancer symptom and presenting to primary care.
The researchers also included studies that assessed time from first presenting to primary care and being referred to secondary care.
|Symptom seriousness recognition is more important to patients than symptom recognition|
|British Journal of Cancer|
Some of the studies described an intervention designed to reduce the patient-to-care intervals.
The research team included 25 studies in the review.
Studies reporting delay intervals demonstrated that the patient phase of delay was greater than the practitioner phase.
The team noted that to patients, the 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.
Dr Mitchell's team concludes, “Greater understanding of patient factors is required, along with evaluation of interventions to ensure appropriate diagnosis, examination and investigation.”