Delay of treatment is associated with advanced stage of rectal cancer but not of colon cancer.
BACKGROUND
Dukes' stage is the most important predictor of prognosis of colorectal cancer, but the association between delay of treatment (DT) and Dukes' stage is still controversial.


METHODS
From 1 January 2001 to 31 July 2002, we conducted a population-based prospective observational study based on 733 Danish colorectal cancer patients. DT was determined through questionnaire-interviews, and Dukes' stage was obtained from medical records and pathological forms. DT was classified into three groups: short (0-60 days), intermediate (61-150 days) and long (>150 days) DT. Dukes' stage was classified into two groups: non-advanced (Dukes' stage A or B) and advanced (Dukes' stage C or D) cancer. Using relative risk (RR) the association between DT and stage was estimated, with short delay as the reference group.


RESULTS
The RR of advanced cancer was 1.0 (95% confidence intervals (CI): 0.8-1.3) for colon cancer patients with an intermediate DT, and 1.1 (95% CI: 0.9-1.4) for patients with a long DT. For rectal cancer patients the RR of advanced cancer was 1.9 (95% CI: 1.1-3.1) for patients with an intermediate DT and 2.1 (95% CI: 1.3-3.4) for patients with a long DT.


CONCLUSIONS
DT was strongly associated with advanced stage of rectal cancer, but not of colon cancer.
Korsgaard
Marianne
M
Department of Surgery L, Aarhus University Hospital, Tage Hansensgade 2, 8000 Aarhus C, Denmark. Marianne.korsgaard@dadlnet.dk <Marianne.korsgaard@dadlnet.dk>
Pedersen
Lars
L
Sørensen
Henrik Toft
HT
Laurberg
Søren
S
D000230:Adenocarcinoma / Q000145:classification / Q000209:etiology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000145:classification / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000145:classification / Q000473:pathology* / Q000628:therapy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors