Delayed Diagnosis of Anal Cancer.

J Gastrointest Surg

University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES), Department of Surgery, University Hospitals, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.

Published: January 2020

Background: Recent literature has shown disparities in diagnosis and treatment of anal cancer. Common perception is that many anal cancer patients may experience a delay in diagnosis and this may contribute to poor outcomes.

Methods: Patients diagnosed with anal cancer at a single academic institution from 2006 to 2017 were retrospectively reviewed. Patients were stratified according to time from symptom onset to diagnosis and divided into three groups: diagnosed within 6 weeks, between 6 weeks and 6 months, and greater than 6 months.

Results: A total of 93 patients were included in this study. Twenty-two (23.7%) were diagnosed within 6 weeks, 48 (51.6%) between 6 weeks and 6 months, and 23 (24.7%) were diagnosed more than 6 months after the onset of symptoms. Over half (57%) of all patients were initially diagnosed with a benign condition. Stage did not vary significantly between groups. Patient diagnosed within 6 weeks had the highest rates of completion of chemotherapy (90%), radiation (95%), and complete response to chemoradiation (77%) but these did not reach statistical significance. There was no difference in recurrence, or overall survival between the groups.

Conclusions: Over half of anal cancer patients were initially misdiagnosed, and 25% were symptomatic for more than 6 months prior to diagnosis. Those patients diagnosed earlier tended to be more likely to receive complete chemoradiation therapy. We were unable to show a statistical difference in outcomes between groups. Further investigation into provider education and awareness of anal cancer is warranted to improve the care of these patients.

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http://dx.doi.org/10.1007/s11605-019-04364-0DOI Listing

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