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Bowel cancer diagnosis delayed by other illness

A new study revealed that additional serious long-term health conditions, such as heart disease, can push a bowel cancer diagnosis back by up to twenty six days.

The latest figures suggest that around 70% of people have at least one of these potentially serious long-term health conditions at the time they are diagnosed with cancer.

The researchers from the University of Exeter analysed clinical data from over 4,500 patients across the UK who were later diagnosed with bowel cancer. In a study published in the British Journal of Cancer, they looked at whether pre-existing illness affected the time it took them to get a cancer diagnosis, making it one of the first studies to investigate this.

They found that if you have a single serious illness or mental health issue unrelated to cancer, such as depression or heart disease, your bowel cancer is diagnosed on average 10 days later than usual , a 13% increase from the usual time taken for a diagnosis. This could go up to over one month when patients had multiple illnesses. These illnesses may take up a lot of time in visits to the GP and leave not enough time available to investigate symptoms or signs linked to cancer.

A bowel cancer sign or symptom which can be explained by a pre-existing condition, such as stomach pains, delayed cancer diagnosis by 9 days on average, a 12% increase from the usual time taken for a diagnosis. These cancer signs and symptom can be explained by the additional illness that the patient has so doctors are ‘led astray’, making it more difficult to arrive at a cancer diagnosis.

They also found that if you have Inflammatory Bowel Disease (IBD), it can delay a bowel cancer diagnosis by 26 days.

Professor Jose Valderas, one of the lead researchers from the University of Exeter Medical School, said: “When you’re trying to diagnose cancer, other illnesses can be a distraction either because they also require attention or because they can mask what would otherwise be flagged as a possible sign of cancer."

“It’s vital that doctors realise that existing illnesses make a diagnosis of cancer more difficult and stay alert to recognize signs and symptoms of cancer as such. It’s also important that patients flag symptoms with their doctor as early as possible, whether it’s unexplained weight loss or changes to your bowel habits.”

Professor Willie Hamilton, one of the lead researchers from the University of Exeter, said: “A ten day delay may not sound much but it may be the difference between a well-planned admission and an emergency admission with a complication. This really matters - as the complications may kill.”

Dr Richard Roope, a GP and Cancer Research UK’s National Cancer Champion, said: “Multiple illnesses are common among cancer patients, which is due to old age, or lifestyle factors such as smoking and obesity which are risk factors not only for cancer but many other diseases. We want patients to be diagnosed as quickly as possible, so it’s important doctors investigate each sign or symptom if it’s unusual, regardless of the patients medical history. It’s also important there’s enough capacity in primary care as more and more patients have illnesses other than cancer. The next Government needs to support GPs to make sure they have time to address complex needs.”

The study, ‘Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records’ is published in the British Journal of Cancer. Authors are Luke TA Mounce, Sarah Price, Jose M Valderas, and Willie Hamilton.

Date: 29 June 2017

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