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Teenagers and young adults with cancer can face long delays before finally being diagnosed
By Teenage Cancer Trust,
Jun 8, 2008 - 3:59:37 AM
London, UK: Three studies to be presented at Teenage Cancer Trust's Fifth International Conference on Teenage and Young Adult Cancer Medicine today (Monday) have thrown light on the extent of delays that teenagers and young adults (TYAs) can face before being diagnosed with cancer, and on some of the reasons why this happens.
Tim Eden, Teenage Cancer Trust Professor of TYA Cancer at the University of Manchester, UK, will tell the conference that in a study of 115 patients with bone tumours, the time between the first symptom and a diagnosis (the symptom interval) ranged from four to 184 weeks with the average time being 15.2 weeks. A second study looked at 95 patients with a variety of tumours and found that the symptom interval ranged from two to 192 weeks with the average length being 9.5 weeks. The symptom interval is made up of the time it takes a young person to seek help and the delay by health professionals in recognising symptoms that require referral and prompt diagnosis.
A third study to be reported to the conference by Ms Sam Smith, a TYA Nurse Consultant in the Teenage Cancer Trust Unit at the Christie Hospital (Manchester, UK), shows that out of 207 young people with cancer who took part in an interactive survey, four out five sought medical help very quickly and only seven per cent delayed for a matter of months. Approximately half of the patients with Hodgkin lymphoma, brain and bone cancers had to visit their general practitioner (GP) four or more times before they were referred to a specialist.
Prof Eden said: It would appear that when we compare these data with studies of children with cancer, teenagers and young adults do face greater delays in diagnosis, particularly for bone and brain tumours and Hodgkin lymphoma. In our studies the professional interval has always been longer than patient symptom interval. There appears to be delay at primary, secondary and tertiary care levels. Interventions are being explored, both to educate the public, and young people in particular, to seek help for worrying symptoms and to empower them to push for referral to specialists. However, it would seem to be more important to raise awareness amongst professionals to recognise worrying signs and to trigger them to be more rapid in their response; in addition, they need to ensure simple and rapid referral pathways for investigation and subsequent treatment. Whether this will improve survival remains unclear but it will reduce anxiety, anger and distrust of doctors.
He added that from most of the research in this field it was difficult to conclude whether delays in diagnosis did definitely result in worse outcome for TYAs. There has been an improvement in survival for teenagers and young adults who develop cancer but it has not been so dramatic as seen in children. It is important to realise that there are other potential reasons for delays in diagnosis, including the particular mix of tumour types seen in this age group, with more resistant forms of cancer, and treatments not yet fully adapted to the tumour biology.
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