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Delay and survival in bladder cancer
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Wallace, D. M. A., Bryan, R. T., Dunn, Janet A., Begum, G. and Bathers, S. (2002) Delay and survival in bladder cancer. BJU International, 89 (9). pp. 868-878. doi:10.1046/j.1464-410X.2002.02776.x
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Official URL: https://onlinelibrary.wiley.com/doi/abs/10.1046/j....
Abstract
Objective: To assess in detail and evaluate the effect on survival of delays in the diagnosis and treatment of cancer (which might lead to a worse prognosis), dividing the delay from onset of symptoms to first treatment into several components, comprising patient delay, general practitioner (GP) delay, and two or more periods of hospital delay. Patients and methods: Data were prospectively collected on 1537 new cases of urothelial cancer in the West Midlands from 1 January 1991 to 30 June 1992. Death information was obtained from the West Midlands Cancer Intelligence Unit and censored at 31 July 2000. The influence of delay times on survival was explored. Results: The median delay from onset of symptoms to GP referral was 14 days (Delay 1), from GP referral to first hospital attendance was 28 days (Delay 2), and from first hospital attendance to first transurethral resection of bladder tumour was 20 days (Delay 3). The median hospital delay (Delay 2+3) was 68 days and the median total delay (Delay 1+2+3) was 110 days. Patients with a shorter Delay 1 had a lower tumour stage and a 5% better 5-year survival. Patients with a shorter hospital delay had worse survival; total delay had no effect on survival. Conclusions: There was significantly better survival for patients referred to hospital within 14 days of the onset of symptoms. The relationship between delay and survival in bladder cancer is complex. Hospital delays may be influenced more by comorbidity than by the characteristics of the tumour. However, the adverse effects of delay seem to be most pronounced for patients with pT1 tumours.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Journal or Publication Title: | BJU International | ||||||
| Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||
| ISSN: | 1464-1603 | ||||||
| Official Date: | June 2002 | ||||||
| Dates: |
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| Volume: | 89 | ||||||
| Number: | 9 | ||||||
| Page Range: | pp. 868-878 | ||||||
| DOI: | 10.1046/j.1464-410X.2002.02776.x | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access |
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