Efecto de la demora atribuible al sistema sanitario en el pronóstico del cáncer colorrectal

Castro, Jesús Daniel Fernández-de; Ureta, Franco Baiocchi; González, Raquel Fernández; Vieito, Noel Pin; Cubiella, Joaquín

doi:10.1016/j.gastrohep.2019.03.012

Cited by 13 publications

(4 citation statements)

References 22 publications

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“…This is a retrospective, cohort, observational study. Data from patients previously collected for a study on the effect of diagnostic delay in symptomatic patients were used [7]. All patients had been diagnosed with CRC as an outpatient in the endoscopy unit of Ourense Teaching Hospital between 2009 and 2017.…”

Section: Methodsmentioning

confidence: 99%

Faecal Immunochemical Test Impact on Prognosis of Colorectal Cancer Detected in Symptomatic Patients

et al. 2022

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The use of the faecal immunochemical test (FIT) to stratify the risk of colorectal cancer (CRC) in symptomatic patients in primary healthcare enables improved referrals to colonoscopy. However, its effect on diagnostic delays or the prognosis of patients has been poorly evaluated in this setting. We performed a retrospective cohort study that included symptomatic patients with outpatient CRC diagnosis between 2009 and 2017. We identified whether FIT had been analysed between initial healthcare contact and diagnostic confirmation. We included 589 patients (male = 65%, 71.7 ± 11.6 years, TNM IV = 17.1%) in the analysis. FIT was performed in 411 (69.8%) patients with a positive result (≥10 µg/g of faeces) in 96.4% of the evaluated patients. The use of FIT was associated with increased diagnostic delay (yes = 159 ± 277 days, no = 111 ± 172 days; p = 0.01). At five years follow up, 193 (32.8%) patients died (151 due to CRC). Mean survival was not modified by the use of FIT or its result (not performed = 46.8 ± 1.5 months, FIT+ = 48.9 ± 1 months, FIT− = 45.6 ± 5.5 months; p = 0.5) in Kaplan–Meier analysis, and was confirmed later in multivariate Cox regression analysis. In conclusion, FIT determination in symptomatic patients in primary healthcare did not modify CRC prognosis.

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Section: Methodsmentioning

confidence: 99%

Faecal Immunochemical Test Impact on Prognosis of Colorectal Cancer Detected in Symptomatic Patients

et al. 2022

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“…There has been some evidence to suggest that a limited healthcare-related delay in diagnosis of colorectal cancer does not impact on outcome. 8 This was a retrospective study and concentrated on stage IV disease. It was not designed to investigate the impact of changes in stage of less advanced disease.…”

Section: Endoscopymentioning

confidence: 99%

Data from a large Western centre exploring the impact of COVID-19 pandemic on endoscopy services and cancer diagnosis

Longcroft‐Wheaton

Tolfree

Gangi

et al. 2020

Frontline Gastroenterol

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ObjectiveThe global COVID-19 pandemic has changed healthcare across the world. Efforts have concentrated on managing this crisis, with impact on cancer care unclear. We investigated the impact on endoscopy services and gastrointestinal (GI) cancer diagnosis in the UK.DesignAnalysis of endoscopy procedures and cancer diagnosis at a UK Major General Hospital. Procedure rates and diagnosis of GI malignancy were examined over 8-week periods in spring, summer and autumn 2019 before the start of the crisis and were compared with rates since onset of national lockdown and restrictions on elective endoscopy. The number of CT scans performed and malignancies diagnosed in the two corresponding periods in 2019 and 2020 were also evaluated.Results2 698 2516 and 3074 endoscopic procedures were performed in 2019, diagnosing 64, 73 and 78 cancers, respectively, the majority being in patients with alarm symptoms and fecal immunochemical test+ve bowel cancer screening population. Following initiation of new guidelines for management of endoscopy services 245 procedures were performed in a 6 week duration, diagnosing 18 cancers. This equates to potentially delayed diagnosis of 37 cancers per million population per month. Clinician triage improved, resulting in 13.6 procedures performed to diagnose one cancer.ConclusionsOur data demonstrate an 88% reduction in procedures during the first 6 weeks of COVID-19 crisis, resulting in 66% fewer GI cancer diagnoses. Triage changes reduced the number of procedures required to diagnose cancer. Our data can help healthcare planning to manage the extra workload on endoscopy departments during the recovery period from COVID-19.

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“…If the test is positive, a colonoscopy is performed. [20][21][22] In Spain, the population-based colorectal cancer screening program was implemented in Catalonia Region in 2000.…”

Section: Introductionmentioning

confidence: 99%

“…If the test is positive, a colonoscopy is performed. [20][21][22] In Spain, the population-based colorectal cancer screening program was implemented in Catalonia Region in 2000.In Castilla La Mancha, it began in April 2015 as a pilot program in three hospitals, one of which was the Virgen de la Luz Hospital in Cuenca. This program, that continuous in progress, is done to women and men between the ages of 50 and 69, who have no previous colorectal pathology and do not have had a colonoscopy in the last 5 years.Modi able CRC risk factors include overweight and obesity, smoking, excessive alcohol consumption, low physical activity and certain types of food, such as processed meat.…”

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confidence: 99%

Colorectal Cancer Prevalence and Survival in Castilla La Mancha (Spain). A Pilot Study

González¹,

Ibáñez²,

Sotos³

2021

Preprint

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Background: Colorectal cancer is the most commonly diagnosed cancer type and the second cause of cancer death in Spain. The primary risk factor for colorectal cancer is age, with 90% of all diagnosed patients aged over 50 years. Prognosis mainly depends on tumour stage. Aim: Conduct a pilot Colorectal Cancer prevalence and survival study in Cuenca (Spain) since there are almost no studies based on small populations. This is the first pilot study about survival in screening of colorectal cancer carried out in hospitals in Castilla La Mancha. Methods and Results: Retrospective descriptive cohort study was performed to include patients with colorectal cancer diagnosed by colonoscopy between May 2015 and April 2016, and who were followed up for 48 months. The study considered sociodemographic and clinical data of the patients. Survival curves were estimated using the Kaplan-Meier method. The proportional hazard rate associated with age, gender, stage and presence of metastasis was calculated using the Cox regression method. 57 patients were included in the study. The mean follow-up was 45.5 months. Ten patients died during the study, in seven cases the cause was colorectal cancer. The percentage of patients alive at 48-month follow-up were 82.4%. Conclusion: Colon cancer is a high-prevalence pathology, with adenocarcinoma being the most common histology. The results seem to indicate that it affects men more frequently, mortality rises with tumour stage at diagnosis and declines with use of chemotherapy. We present a pilot study that could justify large-scale epidemiological studies for the regional surveillance and evolution of colorectal cancer in Spain.

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Efecto de la demora atribuible al sistema sanitario en el pronóstico del cáncer colorrectal

Cited by 13 publications

References 22 publications

Faecal Immunochemical Test Impact on Prognosis of Colorectal Cancer Detected in Symptomatic Patients

Faecal Immunochemical Test Impact on Prognosis of Colorectal Cancer Detected in Symptomatic Patients

Data from a large Western centre exploring the impact of COVID-19 pandemic on endoscopy services and cancer diagnosis

Colorectal Cancer Prevalence and Survival in Castilla La Mancha (Spain). A Pilot Study

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