Younger Adults May Wait Months for CRC Diagnosis

The greatest delay along the colorectal cancer (CRC) treatment pathway in adults younger than 50 occurred between the points of first investigation and diagnosis, according to study results published in BMJ Open Gastroenterology.

“For most patients, the date of diagnosis corresponded to the date of endoscopy,” researchers wrote, “indicating that access to endoscopy was a key driver of the overall wait time for patients.”

The study included 6853 patients, aged 15 to 49, who were diagnosed with CRC in Ontario, Canada, between 2003 and 2018. Just over half the patients were men, the median age was 45, and 25% had stage IV disease. Researchers used administrative codes to investigate time from first presentation with a CRC-related symptom to first investigation, diagnosis, and the start of treatment.

The overall interval between presentation and treatment start was a median 109 days, the study found. For more than a quarter of patients, overall intervals extended beyond 218 days, or 7 months.

Median times were 5 days between presentation and first investigation, according to the study, and 23 days between diagnosis and treatment. The median time between first investigation and diagnosis, however, was much longer: 78 days.

Characteristics associated with longer delay intervals were female sex, distal tumors, and earlier stage disease.

“Given the diagnosis of CRC was commonly made with endoscopy, access to this service is an important target for future research, and potentially intervention for younger patient,” researchers wrote. “Further, we have identified an apparent disparity in outcomes between men and women, with young women experiencing a median 26.5 days longer time to treatment from presentation, warranting further research.”

—Jolynn Tumolo

Reference

Castelo M, Paszat L, Hansen BE, et al. Measurement of clinical delay intervals among younger adults with colorectal cancer using health administrative data: a population-based analysis. BMJ Open Gastroenterol. 2022;9(1):e001022. doi:10.1136/bmjgast-2022-001022