title: Delay in treatment for oesophageal cancer.
abstract: BACKGROUND
  Dysphagia is the cardinal symptom of oesophageal cancer, yet many patients present late. This study examined prospectively the interval between onset of dysphagia and treatment and identified reasons for delay.
  
  
  METHODS
  Patients with histologically confirmed oesophageal carcinoma were questioned about duration of symptoms and about each step of their diagnostic work-up. Delay was estimated from date of onset of symptoms to definitive treatment.
  
  
  RESULTS
  Median delay was 15 weeks for 78 patients with dysphagia, and 17 weeks for 22 patients with other symptoms. The most frequent cause of delay was late presentation to the family doctor (44 per cent). For patients treated with surgery alone there was a trend towards more advanced stage of disease with longer delay to treatment, but no correlation with survival (P = 0.25).
  
  
  CONCLUSIONS
  Lack of awareness of the sinister significance of dysphagia is the most important cause for delay in presentation of patients with oesophageal cancer.
authors.affiliation: Department of Surgery, St James's Hospital, Dublin, Ireland.
authors.forename: J F
authors.initials: JF
authors.lastname: Rothwell
authors.forename: E
authors.initials: E
authors.lastname: Feehan
authors.forename: I
authors.initials: I
authors.lastname: Reid
authors.forename: T N
authors.initials: TN
authors.lastname: Walsh
authors.forename: T P
authors.initials: TP
authors.lastname: Hennessy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000863:Antacids / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003680:Deglutition Disorders / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012017:Referral and Consultation; D013997:Time Factors
chemical_list: D000863:Antacids; D006635:Histamine H2 Antagonists