Abstract
ObjectiveWe performed a cohort study in seven hospitals in Spain to determine the clinical characteristics of incident patients with bladder cancer, the diagnostic process, and the conditions that might affect health care interval times.Results314 patients with bladder cancer were included, 70.3 (Standard Deviation [SD] 11.2) years old and 85.0% male. Clinical stage was T1 in 45.9% of patients. The median interval time between first consultation and diagnosis was of 104.0 days (Inter quartile range [IQR]:112.0; range from 0 to 986), being shorter for those patients who attended a hospital for their first consultation. The median interval time between diagnosis and first treatment was of 0.0 days (IQR: 0.0; range from 0 to 366), being longer when the patient had a pathologic tumor stage ≥ T2a.
Highlights
Bladder cancer is the ninth most common diagnosed cancer worldwide, contributing with 429,793 new cases yearly [1]
As potential predictors we considered the following variables: age, body mass index (BMI), gender, educational level, Eastern Cooperative Oncology Group (ECOG) World Health Organization (WHO) score, setting of the first consultation, primary tumor clinical stage, and time since appearance of first symptoms
The mean BMI was 27.2 (SD: 4.8) and 180 (57.3%) patients were full active according to the ECOG WHO performance status
Summary
Of the 347 patients recruited, 314 patients participated in the study and 33 were excluded for not meeting the inclusion criteria. Patients who went to primary care setting presented an OR of 1.64 (95% CI 1.03–2.63, p = 0.038) of having a diagnostic interval longer than 100 days compared to patients who were first attended at the hospital. There were no significant differences in terms of gender, age, BMI, educational level, ECOG WHO score, or primary tumor stages (Table 2; Additional file 4). Patients in a tumor stage from T2a–T4b presented an OR of 4.39 (95% CI 1.72–11.21, p = 0.002) of having a therapeutic interval longer than 30 days compared to patients with inferior clinical stages. The multivariate analysis showed statistically significant variability among hospitals in the therapeutic interval and the only factor that significantly influenced this interval was the tumor stage (Table 2)
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