Risk factors for delay in symptomatic presentation of leukaemia, lymphoma and myeloma

Howell, Debra A. and Warburton, Fiona and Ramirez, Amanda-Jane and Roman, Eve and Smith, Alexandra G. and Forbes, Lindsay J.L. (2015) Risk factors for delay in symptomatic presentation of leukaemia, lymphoma and myeloma. British Journal of Cancer, 113 . pp. 1114-1120. ISSN 0007-0920. E-ISSN 1532-1827. (doi:https://doi.org/10.1038/bjc.2015.311) (Full text available)

Abstract

Background: UK policy aims to improve cancer outcomes by promoting early diagnosis, which for many haematological malignancies is particularly challenging as the pathways leading to diagnosis can be difficult and prolonged. Methods: A survey about symptoms was sent to patients in England with acute leukaemia, chronic lymphocytic leukaemia (CLL), chronic myeloid leukaemia (CML), myeloma and non-Hodgkin lymphoma (NHL). Symptoms and barriers to first help seeking were examined for each subtype, along with the relative risk of waiting >3 months’ time from symptom onset to first presentation to a doctor, controlling for age, sex and deprivation. Results: Of the 785 respondents, 654 (83.3%) reported symptoms; most commonly for NHL (95%) and least commonly for CLL (67.9%). Some symptoms were frequent across diseases while others were more disease-specific. Overall, 16% of patients (n=114) waited >3 months before presentation; most often in CML (24%) and least in acute leukaemia (9%). Significant risk factors for >3 months to presentation were: night sweats (particularly CLL and NHL), thirst, abdominal pain/discomfort, looking pale (particularly acute leukaemias), and extreme fatigue/tiredness (particularly CML and NHL); and not realising symptom(s) were serious. Conclusions: These findings demonstrate important differences by subtype, which should be considered in strategies promoting early presentation. Not realising the seriousness of some symptoms indicates a worrying lack of public awareness.

Item Type: Article
Uncontrolled keywords: diagnostic delay; patient interval; help seeking
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 22 Jan 2016 16:08 UTC
Last Modified: 01 Dec 2016 14:09 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/53833 (The current URI for this page, for reference purposes)
Forbes, Lindsay J.L.: https://orcid.org/0000-0002-4654-9520
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