Background and objective
The aim of this study is to evaluate the relationship between the interval from first symptom to diagnosis (SDI) and the degree of invasion and survival in lung cancer.
Three hundred seventy-eight patients with lung cancer were included. SDI was defined as the time calculated from the cytohistologic confirmation of the diagnosis of cancer and the first symptoms noted by the patient and attributed to cancer by the physician. The degree of invasion was determined by TNM classification.
The median SDI was 2.1 months, and did not correlate with stage. Survival decreased progressively according to TNM classification. Adjusting for age, sex, SDI and TNM, survival was influenced by age (RR = 1.02) and by staging [Stage (Ib) RR = 1.3; stage (IIIa) RR = 2.6; stage (IIIb) RR = 4.06; stage (IV) RR = 7.5]. SDI was not found to affect survival (RR = 1.01; 95% CI: 0.94–1.08). In the small cell group, SDI also failed to modify survival.
The results of this study indicate that SDI has no effect on the stage or survival of patients with lung cancer.
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- Delays in the diagnosis and surgical treatment of lung cancer.Thorax. 1996; 51: 903-906
- Lung cancer and the delay in the diagnosis: analysis of 300 cases.Rev Assoc Med Bras. 1992; 38: 145-149
- Delay factors in the diagnosis of lung cancer: a public health problem.Rev Paul Med. 1991; 109: 109-112
- Treatment delay in lung cancer-associated atelectasis.Intensive Care Med. 1997; 23: 351
- Causes of delayed treatment of patients with small cell lung cancer.Pneumonol Pol. 1990; 58: 615-619
- Medicolegal analysis of the delayed diagnosis of cancer in 338 cases in the United States.Arch Surg. 1994; 129: 397-403
- Screening for early lung cancer. Results of the Memorial Sloan-Kettering study in New York.Chest. 1984; 86: 44-53
- Screening for lung cancer: the effect of 5–7 years of periodic roentgenographic and cytologic examinations on detection survival and mortality from lung cancer.Am Rev Respir Dis. 1985; 131 ([abstract]): 184
- Lung cancer screening: the Mayo program.J Occup Med. 1986; 28: 746-750
- Guide to clinical preventive services.2nd ed. International Medical Publishing, Inc, Virginia1997 (p. 135–9)
- Canadian guide to clinical preventive health care.Canada Communication Group, Ottawa1994 (p. 780–6)
- Guidelines for the cancer-related checkup: an update.American Cancer Society, Atlanta1993
- Age charts for periodic health examination.American Academy of Family Physicians, Kansas City; MO1994 (reprint No. 510)
- ACR standard for adult chest radiography.2nd ed. American College of Radiology, Reston, VA1993
- Screening for adult respiratory disease.Am Rev Respir Dis. 1983; 128: 768-774
- Screening for lung cancer.in: Eddy D.M Common screening tests. American College of Physicians, Philadelphia1991: 312-325
- The impact of delayed diagnosis of lung cancer on the stage at the time of operation.Eur J Cardiothorac Surg. 1997; 12: 880-884
- Delay in diagnosis of cancer. Possible effects on the stage of disease and survival.Cancer. 1984; 54: 1454-1460
- Influence of “diagnostic delay” upon cancer survival: an analysis of five tumour sites.J Epidemiol Commun Health. 1991; 45: 225-230
- The fight against the delay in the diagnosis of cancer.Biomed Pharmacother. 1984; 38: 321-322
- Factors contributing to delay in diagnosis of testicular tumours.Br Med J (Clin Res Ed). 1985; 290: 356
- Influencia de la demora diagnostica, edad y diferenciacion tumoral de los adenocarcinomas de colon sobre el pronostico de los mismos.Rev Esp Enferm Apar Dig. 1986; 69: 417-419
- Analysis of survival versus patient and doctor delay of treatment in gastrointestinal cancer.Am J Surg. 1974; 127: 210-214
- Delay in diagnosis of colorectal cancer.Lancet. 1979; 26 (1(8126)): 1138
- Staging and prognostic factors: small cell carcinoma.in: Pass H.I Mitchell J.B Johnson D.H Turrissi A.T Lung cancer: principles and practice. Lippicott-Raven, Philadelphia1996: 495-509
- An overview of prognostic factors in small cell lung cancer. A report from the Subcommittee for the Management of Lung Cancer of the United Kingdom Coordinating Committee on Cancer Research.Br J Cancer. 1990; 61: 597-604
- Influence of delays on survival in the surgical treatment of bronchogenic carcinoma.Lung Cancer. 2002; 36: 59-63
- Detection of true pathologic stage I lung cancer in a screening program and the effect on survival.Cancer. 1981; 47: 1182-1187
- El intervalo síntoma-diagnóstico: una paroximación posible a la hisotria natural de la neoplasia.Rev Sanid Hig Publica (Madr). 1989; 63: 91-109
- Estudios españoles sobre la demora diagnóstica y terapeutica en el cáncer. Un análisis crítico de su metodología y resultados.in: Porta M Alvarez-Dardet C Revisiones en salud pública, I. Masson, Barcelona1989: 197-226
- The molecular genetics of lung cancer.Adv Intern Med. 1992; 37: 153-171
- Molecular markers for the diagnosis and prognosis of lung cancer.Cancer. 1992; 69: 1592-1599
- New prognostic factors in lung cancer. Biologic prophets of cancer cell aggression.Chest. 1995; 108: 246-254
- Screening in chronic disease.2nd ed. Oxford University Press, New York1992 (p. 21–42)
- Principles of cancer biology: etiology and prevention.in: DeVita V.T Hellman S Rosenberg S.A Cancer. Principles and practice of oncology. 2nd ed. Lippincont, Philadelphia1982: 33-58
- Outcome in patients with lung cancer found retrospectively to have had evidence of disease on past lung cancer mass screening roentgenograms.Lung Cancer. 2002; 35: 237-241
- Cancer registries: a tool in epidemiology.in: Lilienfeld A.M Reviews in cancer epidemiology. Vol. 2. Elsevier, New York1983: 118-139
- Symptom-to-diagnosis interval and survival in cancers of the digestive tract.Dig Dis Sci. 2002; 47: 2434-2440
- Lung cancer staging. A critical evaluation.Clin Chest Med. 1982; 3: 291-305
- Comorbid and clinical determinants of prognosis in endometrial cancer.Arch Intern Med. 1984; 144: 2004-2009
Accepted: February 12, 2003
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