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    Symptom Signatures and Diagnostic Timeliness in Cancer Patients: A Review of Current Evidence

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    Author
    Koo, MM; Hamilton, W; Walter, FM; Rubin, GP; Lyratzopoulos, G
    Date
    2018-02-01
    Source Title
    Neoplasia
    Publisher
    ELSEVIER SCIENCE INC
    University of Melbourne Author/s
    Walter, Fiona
    Affiliation
    General Practice
    Metadata
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    Document Type
    Journal Article
    Citations
    Koo, M. M., Hamilton, W., Walter, F. M., Rubin, G. P. & Lyratzopoulos, G. (2018). Symptom Signatures and Diagnostic Timeliness in Cancer Patients: A Review of Current Evidence. NEOPLASIA, 20 (2), pp.165-174. https://doi.org/10.1016/j.neo.2017.11.005.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/257626
    DOI
    10.1016/j.neo.2017.11.005
    Abstract
    Early diagnosis is an important aspect of contemporary cancer prevention and control strategies, as the majority of patients are diagnosed following symptomatic presentation. The nature of presenting symptoms can critically influence the length of the diagnostic intervals from symptom onset to presentation (the patient interval), and from first presentation to specialist referral (the primary care interval). Understanding which symptoms are associated with longer diagnostic intervals to help the targeting of early diagnosis initiatives is an area of emerging research. In this Review, we consider the methodological challenges in studying the presenting symptoms and intervals to diagnosis of cancer patients, and summarize current evidence on presenting symptoms associated with a range of common and rarer cancer sites. We propose a taxonomy of cancer sites considering their symptom signature and the predictive value of common presenting symptoms. Finally, we consider evidence on associations between symptomatic presentations and intervals to diagnosis before discussing implications for the design, implementation, and evaluation of public health or health system interventions to achieve the earlier detection of cancer.

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