Katherine Bingmer1, Asya Ofshteyn1, Sharon L Stein1, Emily Steinhagen2. 1. University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES), Department of Surgery, University Hospitals, 11100 Euclid Avenue, Cleveland, OH, 44106, USA. 2. University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES), Department of Surgery, University Hospitals, 11100 Euclid Avenue, Cleveland, OH, 44106, USA. emily.steinhagen@uhhospitals.org.
Abstract
BACKGROUND: Recent literature has shown disparities in diagnosis and treatment of anal cancer. Common perception is that many anal cancer patients may experience a delay in diagnosis and this may contribute to poor outcomes. METHODS: Patients diagnosed with anal cancer at a single academic institution from 2006 to 2017 were retrospectively reviewed. Patients were stratified according to time from symptom onset to diagnosis and divided into three groups: diagnosed within 6 weeks, between 6 weeks and 6 months, and greater than 6 months. RESULTS: A total of 93 patients were included in this study. Twenty-two (23.7%) were diagnosed within 6 weeks, 48 (51.6%) between 6 weeks and 6 months, and 23 (24.7%) were diagnosed more than 6 months after the onset of symptoms. Over half (57%) of all patients were initially diagnosed with a benign condition. Stage did not vary significantly between groups. Patient diagnosed within 6 weeks had the highest rates of completion of chemotherapy (90%), radiation (95%), and complete response to chemoradiation (77%) but these did not reach statistical significance. There was no difference in recurrence, or overall survival between the groups. CONCLUSIONS: Over half of anal cancer patients were initially misdiagnosed, and 25% were symptomatic for more than 6 months prior to diagnosis. Those patients diagnosed earlier tended to be more likely to receive complete chemoradiation therapy. We were unable to show a statistical difference in outcomes between groups. Further investigation into provider education and awareness of anal cancer is warranted to improve the care of these patients.
BACKGROUND: Recent literature has shown disparities in diagnosis and treatment of anal cancer. Common perception is that many anal cancerpatients may experience a delay in diagnosis and this may contribute to poor outcomes. METHODS:Patients diagnosed with anal cancer at a single academic institution from 2006 to 2017 were retrospectively reviewed. Patients were stratified according to time from symptom onset to diagnosis and divided into three groups: diagnosed within 6 weeks, between 6 weeks and 6 months, and greater than 6 months. RESULTS: A total of 93 patients were included in this study. Twenty-two (23.7%) were diagnosed within 6 weeks, 48 (51.6%) between 6 weeks and 6 months, and 23 (24.7%) were diagnosed more than 6 months after the onset of symptoms. Over half (57%) of all patients were initially diagnosed with a benign condition. Stage did not vary significantly between groups. Patient diagnosed within 6 weeks had the highest rates of completion of chemotherapy (90%), radiation (95%), and complete response to chemoradiation (77%) but these did not reach statistical significance. There was no difference in recurrence, or overall survival between the groups. CONCLUSIONS: Over half of anal cancerpatients were initially misdiagnosed, and 25% were symptomatic for more than 6 months prior to diagnosis. Those patients diagnosed earlier tended to be more likely to receive complete chemoradiation therapy. We were unable to show a statistical difference in outcomes between groups. Further investigation into provider education and awareness of anal cancer is warranted to improve the care of these patients.
Authors: Joseph T Hicks; Lu-Yu Hwang; Sarah Baraniuk; Margaret White; Elizabeth Y Chiao; Nkechi Onwuka; Michael W Ross; Alan G Nyitray Journal: Sex Health Date: 2019-02 Impact factor: 2.706