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The symptom-to-treatment delay and stage at the time of treatment in cancer of esophagus.

OBJECTIVE
The main purpose of this investigation was to measure the delay from the first symptom to treatment in esophageal cancer and to analyse the relation between the delay and stage at the time of treatment.


METHODS
A total of 80 patients who were consecutively found to have esophageal cancer between 1 January 2007 and 30 July 2007 at Qilu Hospital of Shandong University in Jinan (China) were included in the retrospective study. Two groups of patients were compared, one group with good prognosis (patients in Stages I and II) and the other group with poor prognosis (patients in Stages III and IV). The symptom-to-treatment delay between the two patient groups was compared using the Mann-Whitney U-test.


RESULTS
The median symptom-to-treatment delay was 2.1 months (range from 0.5 to 24). The total symptom-to-treatment delay was made up with the following components: (i) delay from the first symptoms to first contacting the health-care system (69%); (ii) delay from first contacting the health-care system to histological diagnosis of esophageal cancer (20%); and (iii) delay from histological diagnosis to end point (11%). A significantly shorter median symptom-to-treatment delay was found for patients with Stages I and II compared with III and IV (P = 0.0177).


CONCLUSIONS
Long delays still occur in patients with esophageal cancer. A few months delay before final treatment of esophageal cancer may have an impact on the stage of the cancer, and thereby on the patients' prognosis. Shorting the delay may result in early detection of esophageal cancer.