Behind the waiting time paradox: The diagnostic waiting time has a prognostic significance in cancer

New advanced analysis of data from more than 10,000 Danish, British, Canadian and Spanish patients with colorectal cancer indicates that several weeks of waiting time from the first presentation of symptoms in general practice to the diagnosis are associated with a higher tumor stage and thus a poorer prognosis for patients.

The study sheds empirical and theoretical light on the so-called waiting time paradox and refutes many previous studies that concluded, probably unfounded, that diagnostic waiting time is irrelevant.

Longer diagnostic waiting time is associated with advanced stage of cancer

Data from the study is based on patient records, registries, audits and questionnaires, and includes information about the diagnostic interval – i.e. the time from the first presentation of symptoms to the diagnosis. In addition, they contain information about symptoms at first presentations in primary care, routes of reference, gender, age and histologically stages. The research team behind the analysis re-analyzed all individual datasets, and by the same method analyzed a pooled individual patient data set.

The results from the study show that longer diagnostic intervals are associated with more advanced colorectal cancer. The study cannot define a specific ‘safe’ waiting time as the length of the primary care interval appears to have negative impact from day one. 

Further information

Associate professor Marie Louise Tørring
Research Centre for Cancer Diagnosis in Primary Care (CaP) and Department of Anthropology
Aarhus University, Department of Public Health and and School of Culture and Society
Phone: +458716 2089
mlt@cas.au.dk