A review found an elevated risk of cancer progression with increasing wait time between positive screening and start of diagnostic testing.
Cancer outcomes may be worse for patients with a positive screening result who wait longer for diagnostic testing, according to research published in CA: A Cancer Journal for Clinicians.
An interdisciplinary team of cancer experts from the Population-Based Research Optimizing Screening Through Personalized Regimens Consortium conducted a literature review of breast, cervical, colorectal, and lung cancer studies. The research, published between January 1998 and December 2017, was conducted in an average-risk population, except in lung cancer, and used study designs that provided empirical evidence and evaluated the key questions.
According to the findings, the longer a patient waits for a follow-up evaluation with diagnostic testing after receiving positive cancer screening results, the higher the risk of cancer progression that could lead to worse outcomes.
Although there is no established timeframe for waiting to receive a diagnostic test, the researchers provide suggested targets for each of the 4 cancers within which diagnostic testing should be performed. The researchers recommended targets that range from 60-90 days, but they noted that they were unable to ascribe a certain number of risk points based on exactly how long a patient waits.
Based on their findings, the researchers indicated evidence that waiting longer than 60-90 days will typically cause cancer to progress.
“To ignore these findings is not patient-centered,” Chyke Doubeni, MD, chair of Family Medicine and Community Health and lead author, said in a press release. “The longer a patient waits, the less likely they are to get the diagnostic testing done. There is also a risk that precancerous or early tumors will become more advanced cancers that are more difficult or impossible to cure.”
Cancer screening is proven to reduce the risk of death from some cancers and timeliness to diagnosis is crucial to getting patients started on treatment as soon as possible. Identifying the most effective interventions to reduce time to diagnosis for vulnerable and minority populations is key, the researchers noted.
The study concluded that future research should aim to identify the appropriate data to determine time intervals during which it is potentially safe to wait before undergoing diagnostic testing and work to target patients who have barriers to timely follow up.
Doubeni CA, Gabler NB, Wheeler CM, et al. Timely follow-up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium. CA: A Cancer Journal for Clinicians. 2018. Doi: 10.3322/caac.21452
Cancer Risk Rises as Patients Wait for Diagnostic Testing [news release]. Philadelphia. Penn Medicine’s website. https://www.pennmedicine.org/news/news-releases/2018/april/cancer-risk-rises-as-patients-wait-for-diagnostic-testing. Accessed April 11, 2018.