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Diagnostic timeliness in adolescents and young adults with cancer: a cross-sectional analysis of the BRIGHTLIGHT cohort

Herbert, Annie, Lyratzopoulos, Georgios, Whelan, Jeremy, Taylor, Rachel M, Barber, Julie, Gibson, Faith and Fern, Lorna A (2018) Diagnostic timeliness in adolescents and young adults with cancer: a cross-sectional analysis of the BRIGHTLIGHT cohort The Lancet Child & Adolescent Health, 2 (3). pp. 180-190.

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Abstract

Background: Cancer is the leading cause of disease death for Adolescents and Young Adults (AYA) in developed countries. It is believed that young people experience prolonged intervals to cancer diagnosis but evidence quantifying this and identifying higher risk patient sub-groups is lacking. We examined diagnostic timeliness in a cohort of AYA with incident cancers, identifying factors associated with variation in timeliness. Methods: We analysed data from 830 AYA aged 12-24 who completed BRIGHTLIGHT faceto- face interviews, for variation in the patient interval (time from symptom onset to first healthcare presentation), the number of prereferral General Practitioner (GP) consultations, and the symptom onsetto- diagnosis interval (time from symptom onset to diagnosis). We present descriptive statistics of outcomes by patient characteristics and cancer site and multivariable regression models for adjusted estimates of associations. Findings: Among participants, 27% (204/748) experienced a patient interval of >1 month and 35% (242/701) of those consulting a GP had 3 or more prereferral consultations. The median symptom onset-to-diagnosis interval was 58 days. There was statistically significant variation for 3 or more consultations and symptom onset-to-diagnosis interval by gender (p=0.0093) and cancer site (p<0.0001). Females were more likely to have 3 or more consultations and longer symptom onset-to-diagnosis intervals. Patients with lymphoma or bone tumours were most likely to have 3 or more consultations and those with melanoma least likely; females and those with bone tumours had the longest median symptom onset-to-diagnosis intervals and leukaemia the shortest. Interpretation: The findings benchmark for diagnostic timeliness in young people with cancer, identifying subgroups at higher risk of a prolonged diagnostic journey and providing a point of reference for comparisons. Further work is now required to understand reasons, and prioritise and stratify early diagnosis initiatives for AYA.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Herbert, Annie
Lyratzopoulos, Georgios
Whelan, Jeremy
Taylor, Rachel M
Barber, Julie
Gibson, Faithf.gibson@surrey.ac.uk
Fern, Lorna A
Date : 1 February 2018
Identification Number : 10.1016/S2352-4642(18)30004-X
Copyright Disclaimer : © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Uncontrolled Keywords : Cancer; Diagnosis; Adolescent; Young Adult; Symptom Assessment; BRIGHTLIGHT
Depositing User : Clive Harris
Date Deposited : 16 Jan 2018 15:39
Last Modified : 13 Mar 2018 15:50
URI: http://epubs.surrey.ac.uk/id/eprint/845626

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