Missed opportunities in early diagnosis of symptomatic colorectal cancer.
نویسندگان
چکیده
OBJECTIVE delays in diagnosis of symptomatic colorectal cancer are a reality in our context. This study aims at identifying missed diagnostic opportunities, describing events, clinical clues and most common mistakes, and quantifying delays. MATERIAL AND METHODS an observational descriptive study was performed in order to review all case histories. Two experts reviewed the case histories of all the patients from the 4th Catchment Area of Asturias diagnosed with colorectal cancer in 2009. All data were analysed using bivariate and multivariate logistic regression. RESULTS full information on 119 patients out of 143 patients was collected. 34.45% had a clinical missed opportunity -confidence interval (CI) 95%: 30.92-39.68-. Outcomes show an average of 2.41 missed opportunities and 2.61 diagnostic clinical clues per patient. The number of patients with missed opportunities was significantly higher. The total amount of co-morbidities was higher in patients with missed opportunities (2.7). This was the main determinant. The main diagnostic key was iron-deficiency anaemia (46.3%). It produced the longest delay (300 days). Not having requested diagnostic tests was the most common mistake (43.3%). Having at least one missed opportunity entailed an average delay of 235.8 days between the first visit to the office and the referral to a consultant. CONCLUSIONS in clinical practice, missed opportunities to start a diagnostic assessment in patients with presumptive diagnosis of colorectal cancer are common. The most significant clinical clue and the one generating the longest delay is iron-deficiency anaemia. The diagnostic delay is important and is caused mainly by not identifying symptoms.
منابع مشابه
Epigenetics in diagnosis of colorectal cancer
Colorectal cancer (CRC) is a third most common epithelial carcinoma. CRC is known to develop from the early precancerous lesion to full blown malignancy via definite phases due to cumulative mutations and aberrant methylation of number of genes. The use of serum biomarkers that is non-invasive to discriminate cancer patients from healthy persons will prove to be an important tool to improve the...
متن کاملInvestigating the biomarker role of piRNAs in the diagnosis of colorectal cancer
Background & objectives: Colorectal cancer (CRC) is the most common gastric cancer and third lethal cancer worldwide. Despite development in diagnostic and treatment methods, due to the lack of typical symptoms in the early stages, most patients are diagnosed in the end stages. Therefore, finding simple, inexpensive, highly sensitive and specific diagnostic methods for early detection and prog...
متن کاملComparison of Random Forest and Logistic Regression Methods in Predicting Mortality in Colorectal Cancer Patients and its Related Factors
Background and Objectives: The purpose of this study was to predict the mortality rate of colorectal cancer in Iranian patients and determine the effective factors on the mortality of patients with colorectal cancer using random forest and logistic regression methods. Methods: Data from 304 patients with colorectal cancer registry from the Gastroenterology and Liver Research Center of Shah...
متن کاملGeneral discussion and future perspectives
This thesis addresses multiple issues concerning population-based screening for colorectal cancer (CRC), as is currently in preparation in the Netherlands. When starting this research project in January 2005, a number of questions were postulated that remained to be answered by that time. Since then, many of these issues have been addressed, several of which by studies described in this thesis....
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva
دوره 104 7 شماره
صفحات -
تاریخ انتشار 2012