TY - JOUR
T1 - The nature and frequency of abdominal symptoms in cancer patients and their associations with time to help-seeking
T2 - evidence from a national audit of cancer diagnosis
AU - Koo, Minjoung Monica
AU - von Wagner, Christian
AU - Abel, Gary A.
AU - McPhail, Sean
AU - Hamilton, William
AU - Rubin, Greg P.
AU - Lyratzopoulos, Georgios
N1 - Publisher Copyright:
© 2018 Oxford University Press. All rights reserved.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - A B S T R A C T Background Raising awareness of possible cancer symptoms is important for timely help-seeking; recent campaigns have focused on symptom groups (such as abdominal symptoms) rather than individual alarm symptoms associated with particular cancer sites. The evidence base supporting such initiatives is still emerging however; understanding the frequency and nature of presenting abdominal symptoms among cancer patients could inform the design and evaluation of public health awareness campaigns. Methods We examined eight presenting abdominal symptoms (abdominal pain, change in bowel habit, bloating/distension, dyspepsia, rectal bleeding, dysphagia, reflux and nausea/vomiting) among 15 956 patients subsequently diagnosed with cancer in England. We investigated the cancer site case-mix and variation in the patient interval (symptom-onset-to-presentation) by abdominal symptom. Results Almost a quarter (23%) of cancer patients presented with abdominal symptoms before being diagnosed with one of 27 common and rarer cancers. The patient interval varied substantially by abdominal symptom: median (IQR) intervals ranged from 7 (0–28) days for abdominal pain to 30 (4–73) days for dysphagia. This variation persisted after adjusting for age, sex and ethnicity (P < 0.001). Conclusions Abdominal symptoms are common at presentation among cancer patients, while time to presentation varies by symptom. The need for awareness campaigns may be greater for symptoms associated with longer intervals to help-seeking.
AB - A B S T R A C T Background Raising awareness of possible cancer symptoms is important for timely help-seeking; recent campaigns have focused on symptom groups (such as abdominal symptoms) rather than individual alarm symptoms associated with particular cancer sites. The evidence base supporting such initiatives is still emerging however; understanding the frequency and nature of presenting abdominal symptoms among cancer patients could inform the design and evaluation of public health awareness campaigns. Methods We examined eight presenting abdominal symptoms (abdominal pain, change in bowel habit, bloating/distension, dyspepsia, rectal bleeding, dysphagia, reflux and nausea/vomiting) among 15 956 patients subsequently diagnosed with cancer in England. We investigated the cancer site case-mix and variation in the patient interval (symptom-onset-to-presentation) by abdominal symptom. Results Almost a quarter (23%) of cancer patients presented with abdominal symptoms before being diagnosed with one of 27 common and rarer cancers. The patient interval varied substantially by abdominal symptom: median (IQR) intervals ranged from 7 (0–28) days for abdominal pain to 30 (4–73) days for dysphagia. This variation persisted after adjusting for age, sex and ethnicity (P < 0.001). Conclusions Abdominal symptoms are common at presentation among cancer patients, while time to presentation varies by symptom. The need for awareness campaigns may be greater for symptoms associated with longer intervals to help-seeking.
KW - Keywords cancer
KW - health promotion
KW - public health
UR - http://www.scopus.com/inward/record.url?scp=85054080425&partnerID=8YFLogxK
U2 - 10.1093/pubmed/fdx188
DO - 10.1093/pubmed/fdx188
M3 - Article
C2 - 29385513
AN - SCOPUS:85054080425
SN - 1741-3842
VL - 40
SP - E388-E395
JO - Journal of Public Health (United Kingdom)
JF - Journal of Public Health (United Kingdom)
IS - 3
ER -