“Timing is everything.”

This quote is particularly relevant to cancer diagnosis, the timing of which can determine the efficacy of treatment, the patient’s quality of life, and whether or not they’ll survive, according to The Lancet Oncology.

Whitaker K. Earlier diagnosis: the importance of cancer symptoms. The Lancet Oncology. 2020;21(1):6–8.

 

Too many patients miss out on the opportunity to heal their cancer due to delayed diagnosis. In order to give patients with cancer a greater chance at surviving and enjoying their lives, doctors can work to better identify the early warning signs and implement regular screening tests.

 

Why the delay in diagnosis?

 

When it comes to the timing of a cancer diagnosis, there are a few reasons why the diagnosis can be delayed.

On the other hand, primary care physicians can also overlook symptoms that may be indicative of cancer, and not refer them on time. Patients in secondary care also may not be seen on time or may be referred to the wrong specialist.

The authors of the South Asian Journal of Cancer article also note that delays can be a function of the type of tumor presentation or where the cancer is located.

The researchers studied 158 patients with head and neck cancers, the most common being oral cavity (43.7%) and pharynx (29.1%). These cancers were predominantly identified in Stage II (median).

In the analysis of 252 women with breast cancer, the most common stage observed was Stage III.

One systematic review published by The Oncologist takes a comprehensive look at delays and barriers associated with advanced stage presentation of cancer in low- and middle-income countries (LMICs).

Brand NR, Qu LG, Chao A, Ilbawi AM. Delays and barriers to cancer care in low- and middle-income countries: a systematic review. The Oncologist. 2019;24(12):e1371-e1380.

 

The review found that when compared with patients from other income groups, patients from low income countries experience remarkably longer access intervals, or time between the onset of symptoms and addressing them with a health professional.

"Studies from low‐income countries had significantly longer access intervals (median, 6.5 months) compared with other country income groups," the authors wrote.

"Patients with breast cancer had longer delay intervals than patients with childhood cancer. No significant variation existed between geographic regions," they added. "Low health literacy was reported most frequently in studies describing barriers to cancer diagnosis and was associated with lower education level, no formal employment, lower income, and rural residence."

This data highlights the need for early diagnosis strategies to address barriers associated with later stage presentation of cancer in patients from LMICs.

 

Early screening tests

 

Knowing that patients who get an early diagnosis have a better overall chance of survival, what can doctors do to offer as timely a diagnosis as possible?

Early diagnosis relies on early detection, which is commonly achieved through screening tests.

According to the CDC, regular screening tests for breast, cervical, and colorectal cancers can help physicians detect them early on.

How to prevent cancer or find it early. Centers for Disease Control and Prevention. May 19, 2022.

 

 

For example, mammograms, Pap tests, and colorectal screening tests can all aid in early detection of corresponding cancers (sometimes before patients even experience symptoms).

Experts also encourage patients who are at high risk of lung cancer to undergo screening, which can be done with low-dose computed tomography (LDCT). This form of screening may be crucial for those who are 50 to 80 years of age and have a history of heavy smoking, actively smoke now, or quit within the past 15 years.

Outside of screening tests, the authors of the South Asian Journal of Cancer article note that it’s important for all stakeholders involved to do their best to lower the barriers to timely cancer diagnosis. You can do so by:

• Promoting social awareness of cancer signs and screening tests

• Regularly updating primary care physicians about alarming symptoms of cancer

• Developing guidelines to identify these symptoms

• Promoting continuity of care

• Enabling patients’ access to specialist expertise through prompt referral

Being sure that your patients avail themselves of early detection methods can help you address the issue of delayed diagnosis and help patients experience a healthy life for as long as possible.