Achieving a timely diagnosis for teenagers and young adults with cancer: the ACE 'too young to get cancer?' study
| Autor: | Dommett, Rachel, Pring, Hannah, Cargill, Jamie, Beynon, Paul, Cameron, Alison, Cox, Rachel, Nechowska, Aoife, Wint, Alison, Stevens, Michael C.G. |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Adolescent Primary Health Care Routes to diagnosis Time to diagnosis lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Primary care lcsh:RC254-282 Secondary Care Time Time-to-Treatment Secondary care Young Adult Neoplasms TYA Humans Female Delivery of Health Care Nurse Specialists Referral and Consultation Early Detection of Cancer Research Article |
| Zdroj: | BMC Cancer BMC Cancer, Vol 19, Iss 1, Pp 1-15 (2019) Dommett, R, Pring, H, Cargill, J, Beynon, P, Cameron, A, Cox, R, Nechowska, A, Wint, A & Stevens, M C G 2019, ' Achieving a timely diagnosis for teenagers and young adults with cancer : The ACE "too young to get cancer?" study ', BMC Cancer, vol. 19, no. 1, 616 . https://doi.org/10.1186/s12885-019-5776-0 |
| ISSN: | 1471-2407 |
| DOI: | 10.1186/s12885-019-5776-0 |
| Popis: | BackgroundTime to diagnosis (TTD) concerns teenagers and young adults (TYA) with cancer and may affect outcome. MethodsHealthcare records from 105 TYA in a regional cancer service were assessed to document events from 1st symptom to treatment start. Detailed pathway construction was possible for 104 patients and allowed a multidisciplinary panel review of each pathway with assessment of good practice and lessons for the future. Results1st presentation was to primary care in 86%, and 93% consulted in primary care before diagnosis. Routes to Diagnosis were 45% via urgent Two Week Wait pathways and 38% as emergency referrals. Total Interval (time from 1st presentation to treatment start) was median 63 (range 1-59) days, varying within/between diagnoses. Patient interval (time from 1st symptom to 1st presentation) was longest for lymphoma, carcinoma and bone tumour (medians: 9, 12, 20 days). Overall, time in primary care was short (median 3, range 0-537 days) compared to secondary care (median 29, range 0-195 days) and longest for lymphoma, carcinoma, brain/CNS (medians: 10, 15, 16 days). Specialist Care interval (time from 1st specialist visit to treatment start) was longest for bone, brain/CNS, lymphoma, carcinoma (medians: 30, 33, 36, 48 days). 40% pathways were rated as showing good/best practice but 16% were less than satisfactory. Continued safety-netting/support was identified from PC but there were opportunities for improvement in transition through secondary care.ConclusionsPrevious reports of prolonged TTD have focused on delay in referral from primary care but this study suggests that delay can be reduced by optimising management in secondary care. |
| Databáze: | OpenAIRE |
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