Symptom-to-Diagnosis Interval and Survival in Cancers of the Digestive Tract

The objective was to identify the main correlates of the symptom-to-diagnosis interval (SDI) and to analyze their influence upon the survival in patients with cancers of the digestive tract. Two hundred forty-eight symptomatic patients with cancer of the esophagus (N = 31), stomach (N = 70), colon (N = 84), and rectum (N = 66) were interviewed and prospectively followed (median follow-up of 77 months). Cox's regression was used to assess the relative risk (RR) of death according to SDI. The median SDI was about 4 months, with nonsignificant differences by sex, age, social class, family history of cancer, or tumor site. The RR of death varied significantly by age (P = 0.012), tumor site (P 6–12 months, and 0.81 (95% CI: 0.44–1.49) for SDI > 12 months. These results do not imply that specific actions to hasten diagnosis must of necessity be ineffective, but underscore what a challenging task the secondary prevention of cancer remains.