[PAPPS Expert Groups. Cancer prevention recommendations: Update 2022]

[Time intervals for diagnosis and treatment in breast cancer patients]

OBJECTIVE

To describe the delay in the diagnosis of breast cancer in primary care and to identify the patient, care process and disease variables involved in the delay to diagnosis and treatment.

DESIGN

Retrospective study with follow-up of a cohort of women with breast cancer, from the first symptoms to the start of treatment. SITE: In total 24 family medicine practices with information from both primary care and hospital settings.

PARTICIPANTS

446 women were evaluated (period 2014-2023).

MAIN MEASUREMENTS

Patient characteristics (age, history and comorbidity), care process (screening, consultation site and referral priority) and disease characteristics (stage, presentation and risk factors) were included. Time intervals considered included, among others, «primary care interval», «health system interval», «diagnosis interval» and «treatment interval».

RESULTS

The mean value of the «primary care interval» was 24.7days (median: 16); that of the «hospital care interval», 77.2days (median: 68); and that of the «health system interval», 93.6days (median: 83). Multiple linear regression showed a significantly shorter duration of the interval in women referred preferentially, in advanced stages, with a breast lump at presentation and with risk factors.

CONCLUSIONS

Most are diagnosed in early stages at the health centre. The duration of the «health system interval» is shorter in preferential referrals, when the form of presentation is a breast lump, with risk factors and in advanced stages.

Hospitalization burden associated with anus and penis neoplasm in Spain (2016-2020)

In 2020, there were approximately 50,865 anal cancer cases and 36,068 penile cancer cases worldwide. HPV is considered the main causal agent for the development of anal cancer and one of the causal agents responsible for the development of penile cancer. The aim of this epidemiological, descriptive, retrospective study was to describe the burden of hospitalization associated with anal neoplasms in men and women and with penis neoplasms in men in Spain from 2016 to 2020. The National Hospital Data Surveillance System of the Ministry of Health, Conjunto Mínimo Básico de Datos, provided the discharge information used in this observational retrospective analysis. A total of 3,542 hospitalizations due to anal cancer and 4,270 hospitalizations due to penile cancer were found; For anal cancer, 57.4% of the hospitalizations occurred in men, and these hospitalizations were also associated with significantly younger mean age, longer hospital stays and greater costs than those in women. HIV was diagnosed in 11.19% of the patients with anal cancer and 1.74% of the patients with penile cancer. The hospitalization rate was 2.07 for men and 1.45 for women per 100,000 in anal cancer and of 4.38 per 100,000 men in penile cancer. The mortality rate was 0.21 for men and 0.12 for women per 100,000 in anal cancer and 0.31 per 100.000 men in penile cancer and the case-fatality rate was 10.07% in men and 8,26% in women for anal cancer and 7.04% in penile cancer. HIV diagnosis significantly increased the cost of hospitalization. For all the studied diagnoses, the median length of hospital stays and hospitalization cost increased with age. Our study offers relevant data on the burden of hospitalization for anal and penile cancer in Spain. This information can be useful for future assessment on the impact of preventive measures, such as screening or vaccination in Spain.

[Cancer prevention recommendations: Update 2024]

Cancer is one of the main causes of morbidity and mortality. Environmental factors along with lifestyle: tobacco and alcohol consumption, unhealthy diet and sedentary lifestyle and lack of physical activity, are some of the risk factors that have caused an increase in cancer. This article updates the evidence and recommendations for cancer prevention strategies through screening in asymptomatic patients, as well as early detection of signs and symptoms in medium-risk and high-risk populations.