Category Archives: Theory and Practice of Medicine

Examples of missed opportunities for an earlier cancer diagnosis

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Alpujarras, Granada, Spain

Some Situations prone to a missed diagnosis in cancer

Tumor Clinical situation
Lung cancer False negative X-ray: delays six times longer.

Superior sulcus tumours  treated for musculoskeletal shoulder pain.

Older and socially deprived groups

 

 

 

Larynx Performing mirror examination significantly shortened the professional diagnostic delay.

Women double probability of diagnostic delay

Upper gastrointestinal Taking acid suppression for symptoms delays the diagnosis
Gastrointestinal Inappropriate use of a rapid access to an endoscopy service
Cervix cancer Pregnancy: delayed diagnosis
Rectal cancer Negative barium enema within the year prior to diagnosis as a cause of the delayed diagnosis  

 

 

 

 

Diagnostic delay in cancer: why we can not solve the equation?

sam_2577
Amish territory

Diagnostic delay in cancer is a difficult subject to study with many confounder factors. Several papers have been published with controversial results about the relationship between delay and survival, although there is a clear tendence for a worse prognosis with longer delays. We will expose some of the confounder factors and biases that can interact with the association between  delay and survival.

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Diagnostic delay and models of cancer care

 

 

diagnostico-cancer-no-especifico2

There are three basic models of cancer care in the literature, two of them derived from the world of the psychology , the Safer model [23]  and  the Andersen model [24], widely used in publications, and the third one coming from the medical general practice world, the Olesen model [25] developed in Denmark.  Based on her publication we think is also worth to introduce a fourth model, the Walter model [26], a refinement of the Andersen model, that introduces the term “time interval” rather than delay.

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How can we define delay in cancer?

Clary St., Boston, by Lourdes Alonso

The time between symptom recognition and a definitive diagnosis have been described in many terms including ‘Time-to-Diagnosis’ (TtD), delay to diagnosis, pre-diagnostic interval and duration of symptoms in the literature [6] and we will use TtD across this paper. The concept of the term “delay” assumes that there is an ideal period of time to arrive to a diagnosis in a patient with cancer

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Diagnostic delay in cancer: a complex landscape

india
People from India

There is a good rational to assume that the smaller a tumor  the better the outcome. However, there are several  variables and prognostic factors involved in the clinical evolution of a patient, not only time. The process of diagnostic in cancer have been artificially divided in different segments related to the patient, the appointment with a doctor and the pattern of referral. In all these models the physician looks like the perfect machine prepared for a perfect diagnosis….

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