Colorectal Cancer Survival is not Affected by Delay in Diagnosis

Introduction: We previously published that patients were significantly less likely to have Australian clinicopathological stage (ACPS) ‘A’ colorectal cancer (CRC) tumours if there had been delayed diagnosis or if they were male. The aim of this study was to evaluate in the same group of patients the effects of delayed diagnosis, gender, age, tumour site and stage on long term survival. Methods: All 100 patients from the 1995 study were followed up until death or between October 2000 and December 2000. Cancer specific survival (CSS) and overall survival (OS) curves were calculated by Kaplan-Meier method and compared by the log-rank test. Multivariate analysis was performed by Cox proportional hazards model. Results: The entire cohort’s 5-year CSS was 51% and OS was 44%. Survival was significantly better for stage A tumours (CSS and OS p< 0.001) and for right sided CRC tumours (CSS p=0.026, OS p=0.037). Delayed diagnosis, gender and age were not significantly associated with survival (CSS or OS). Tumour site and stage remained significant independent prognostic indicators of survival on multivariate analysis. Conclusion: Delay in diagnosis of symptomatic CRC does not have an effect on long-term cancer specific or overall survival. This does not detract from the importance of early diagnosis in clinical practice but reinforces the role of tumour site and stage in survival of CRC.