Longer delays associated with better survival

Patients who experience the longest delay in treatment are more likely to survive, despite the popular assumption that delay has a significant and harmful impact on survival, finds a study in this week's BMJ.

Researchers collected data from the case notes of 703 women resident in Scotland who were diagnosed between 1 January 1996 and 31 December 1997 as having endometrial cancer. They calculated time intervals from the dates of general practitioner referral letters, clinic appointments, investigations, and operations.

They found that delay and survival were inversely related: women with the shortest delay had more advanced disease and survival was least likely for these patients.

The traditional view is that delay caused by organisational defects has an adverse effect on the disease: this influences survival. "Our study suggests that disease influences delay, and so delay is a confounding factor," say the authors.

The fact that the strongest effect between delay and survival is seen in the interval between referral and the first hospital visit suggests that general practitioners communicate information related to presentation in some way to consultants, they add. This communication ensures that consultants respond faster to patients who are at higher risk.

Consultants seem to be able, from first clinic visit, to differentiate patients at greater risk and to ensure that cancer is diagnosed and treated faster, they conclude.


Contact: Emma Wilkinson
BMJ-British Medical Journal

Page: 1

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