Markers and measures of timeliness of cancer diagnosis after symptom onset: A conceptual framework and its implications

摘要

In spite of progress in the development and delivery of screening programmes, currently most cancer patients worldwide are diagnosed symptomatically [1]. Consequently, several countries are implementing policies that aim to help diagnose cancer as soon as possible after symptom onset. For example, in England, the National Awareness and Early Diagnosis Initiative (or NAEDI) was launched in 2008, encompassing a wide spectrum of policy and research funding streams [2]. This initiative substantially amplified previous policies aiming to accelerate the diagnostic investigation of patients suspected to have cancer through the 'two-week wait' referral pathway and related guidance to general practitioners [3,4]. Similar initiatives are also in progress in several countries or jurisdictions [5-9]. In Denmark and England the introduction of early diagnosis policies was also motivated by concerns about relatively lower survival of their cancer patients compared with those diagnosed in some other European countries, thought to be at least in major part attributable to advanced stage at diagnosis [10,11].