Jesús Daniel Fernández-de Castro1, Franco Baiocchi Ureta2, Raquel Fernández González3, Noel Pin Vieito2, Joaquín Cubiella Fernández4. 1. Servicio de Aparato Dixestivo, Complexo Hospitalario Universitario de Ourense, Ourense, España. Electronic address: Jesus.Daniel.Fernandez.de.Castro@sergas.es. 2. Servicio de Aparato Dixestivo, Complexo Hospitalario Universitario de Ourense, Ourense, España. 3. Servicio de Medicina Interna, Complexo Hospitalario Universitario de Ourense, Ourense, España. 4. Servicio de Aparato Dixestivo, Complexo Hospitalario Universitario de Ourense, Ourense, España; Instituto de Investigación Sanitaria Galicia Sur, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Ourense, España.
Abstract
OBJECTIVES: To analyse the effect of a delay attributable to the healthcare system on a consecutive cohort of outpatients diagnosed with colorectal cancer in the healthcare area of Ourense (Spain). PATIENTS AND METHODS: We performed a retrospective cohort study that included patients diagnosed between 2009 and 2017. Delay attributable to the healthcare system was defined as the time between the first consultation with symptoms and the diagnostic confirmation. A logistic regression model was performed to evaluate the relationship between stage IV CRC and diagnostic delay. To analyse which variables were associated independently with overall mortality and mortality due to CRC we used a Cox regression model. RESULTS: 575 patients were included (men 64.5%, age 71.9 ± 11.5 years), with a delay attributable to the healthcare system of 115 ± 153 days. None of the variables analysed were associated with tumour stage at diagnosis. With a mean follow-up of 30.6 ± 21 months, 121 patients died (79.3% due to CRC). The variables independently associated with CRC-related mortality were metastatic CRC (HR 50.65, 95% CI 12.28-209), age (HR 1.04, 95% CI 1.02-1.05) and colonoscopy requested from the Primary Healthcare level (HR 0.55, 95% CI 0.36-0.88). CONCLUSIONS: Diagnostic delay attributable to the healthcare system is not related to the prognosis or stage of CRC. However, a direct referral to colonoscopy from the Primary Healthcare level reduces the risk of mortality in our patients.
OBJECTIVES: To analyse the effect of a delay attributable to the healthcare system on a consecutive cohort of outpatients diagnosed with colorectal cancer in the healthcare area of Ourense (Spain). PATIENTS AND METHODS: We performed a retrospective cohort study that included patients diagnosed between 2009 and 2017. Delay attributable to the healthcare system was defined as the time between the first consultation with symptoms and the diagnostic confirmation. A logistic regression model was performed to evaluate the relationship between stage IV CRC and diagnostic delay. To analyse which variables were associated independently with overall mortality and mortality due to CRC we used a Cox regression model. RESULTS: 575 patients were included (men 64.5%, age 71.9 ± 11.5 years), with a delay attributable to the healthcare system of 115 ± 153 days. None of the variables analysed were associated with tumour stage at diagnosis. With a mean follow-up of 30.6 ± 21 months, 121 patients died (79.3% due to CRC). The variables independently associated with CRC-related mortality were metastatic CRC (HR 50.65, 95% CI 12.28-209), age (HR 1.04, 95% CI 1.02-1.05) and colonoscopy requested from the Primary Healthcare level (HR 0.55, 95% CI 0.36-0.88). CONCLUSIONS: Diagnostic delay attributable to the healthcare system is not related to the prognosis or stage of CRC. However, a direct referral to colonoscopy from the Primary Healthcare level reduces the risk of mortality in our patients.
Authors: Matthew Castelo; Colin Sue-Chue-Lam; Lawrence Paszat; Teruko Kishibe; Adena S Scheer; Bettina E Hansen; Nancy N Baxter Journal: PLoS One Date: 2022-09-12 Impact factor: 3.752
Authors: María Padilla-Ruiz; María Morales-Suárez-Varela; Francisco Rivas-Ruiz; Julia Alcaide; Esperanza Varela-Moreno; Irene Zarcos-Pedrinaci; Teresa Téllez; Nerea Fernández-de Larrea-Baz; Marisa Baré; Amaia Bilbao; Cristina Sarasqueta; Urko Aguirre-Larracoechea; José María Quintana; Maximino Redondo Journal: Int J Environ Res Public Health Date: 2022-03-18 Impact factor: 3.390
Authors: Noel Pin-Vieito; Laura García Nimo; Luis Bujanda; Begona Román Alonso; María Ángeles Gutierrez-Stampa; Vanessa Aguilar-Gama; Isabel Portillo; Joaquín Cubiella Journal: United European Gastroenterol J Date: 2021-03-01 Impact factor: 4.623