Greenlandic patients with colorectal cancer: symptomatology, primary investigations and differences in diagnostic intervals between Nuuk and the rest of the country
Background: Colorectal cancer (CRC) is a potentially fatal disease, and expedited referral and treatment is needed to ensure early detection. Objective: We aimed to assess the symptomatology of Greenlandic patients with CRC and the primary investigations initiated before referral to Dronning Ingrids...
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2017
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ftdoajarticles:oai:doaj.org/article:c237ac338f27471ea9bf479088551a1a 2023-05-15T15:18:26+02:00 Greenlandic patients with colorectal cancer: symptomatology, primary investigations and differences in diagnostic intervals between Nuuk and the rest of the country Johan Tolstrup Rasmus Chemnitz Madsen Maria Vandborg Sneftrup Birgit Niclasen 2017-01-01T00:00:00Z https://doi.org/10.1080/22423982.2017.1344086 https://doaj.org/article/c237ac338f27471ea9bf479088551a1a EN eng Taylor & Francis Group http://dx.doi.org/10.1080/22423982.2017.1344086 https://doaj.org/toc/2242-3982 2242-3982 doi:10.1080/22423982.2017.1344086 https://doaj.org/article/c237ac338f27471ea9bf479088551a1a International Journal of Circumpolar Health, Vol 76, Iss 1 (2017) Colorectal cancer Greenland Primary care practitioners’ delay hospital delay symptomatology diagnostic interval Arctic medicine. Tropical medicine RC955-962 article 2017 ftdoajarticles https://doi.org/10.1080/22423982.2017.1344086 2022-12-31T00:50:16Z Background: Colorectal cancer (CRC) is a potentially fatal disease, and expedited referral and treatment is needed to ensure early detection. Objective: We aimed to assess the symptomatology of Greenlandic patients with CRC and the primary investigations initiated before referral to Dronning Ingrids Hospital in Nuuk for further diagnostic workup. Primary care interval (first consultation until referral), hospital interval (referral until diagnosis) and diagnostic interval (first consultation until diagnosis) were calculated and compared between patients living in Nuuk and in other places in Greenland (“the Coast”). Design: This was a retrospective, register-based study of all patients in Greenland diagnosed with CRC from 2008 through 2011. Medical history was obtained and investigated by reviewing the primary care charts. Results: In total 113 patients were identified from the Greenlandic cancer database or pathology reports. About 80% of the patients were asked about blood in the stools and changes of bowel habits, and the majority responded positively to this. Abdominal examination was performed for 78%, 65% had a rectal examination performed, 22% a proctoscopy performed and 51% a haemoglobin level measured. The median primary care interval was 4 days in Nuuk vs. 55 days for patients from “the Coast” (p=0.01); the median diagnostic interval was 55 days in Nuuk vs. 95 days for patients from “the Coast” (p=0.04). Median hospital interval was similar for both groups (23 days vs 24 days; p=0.86). Women had a median primary care interval of 70 days vs. 15 days for men (p=0.06). Conclusions: Patients with CRC presented classic symptomatology of CRC. Primary care interval and diagnostic interval were significantly longer for patients from “the Coast” compared with Nuuk. Women tended to have longer primary care interval. A more standardised examination should be implemented and a national CRC screening programme should be considered to reduce the difference in diagnostic interval and ensure timely referral. Article in Journal/Newspaper Arctic Circumpolar Health Greenland greenlandic International Journal of Circumpolar Health Nuuk Directory of Open Access Journals: DOAJ Articles Arctic Greenland Nuuk ENVELOPE(-52.150,-52.150,68.717,68.717) International Journal of Circumpolar Health 76 1 1344086 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Colorectal cancer Greenland Primary care practitioners’ delay hospital delay symptomatology diagnostic interval Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Colorectal cancer Greenland Primary care practitioners’ delay hospital delay symptomatology diagnostic interval Arctic medicine. Tropical medicine RC955-962 Johan Tolstrup Rasmus Chemnitz Madsen Maria Vandborg Sneftrup Birgit Niclasen Greenlandic patients with colorectal cancer: symptomatology, primary investigations and differences in diagnostic intervals between Nuuk and the rest of the country |
topic_facet |
Colorectal cancer Greenland Primary care practitioners’ delay hospital delay symptomatology diagnostic interval Arctic medicine. Tropical medicine RC955-962 |
description |
Background: Colorectal cancer (CRC) is a potentially fatal disease, and expedited referral and treatment is needed to ensure early detection. Objective: We aimed to assess the symptomatology of Greenlandic patients with CRC and the primary investigations initiated before referral to Dronning Ingrids Hospital in Nuuk for further diagnostic workup. Primary care interval (first consultation until referral), hospital interval (referral until diagnosis) and diagnostic interval (first consultation until diagnosis) were calculated and compared between patients living in Nuuk and in other places in Greenland (“the Coast”). Design: This was a retrospective, register-based study of all patients in Greenland diagnosed with CRC from 2008 through 2011. Medical history was obtained and investigated by reviewing the primary care charts. Results: In total 113 patients were identified from the Greenlandic cancer database or pathology reports. About 80% of the patients were asked about blood in the stools and changes of bowel habits, and the majority responded positively to this. Abdominal examination was performed for 78%, 65% had a rectal examination performed, 22% a proctoscopy performed and 51% a haemoglobin level measured. The median primary care interval was 4 days in Nuuk vs. 55 days for patients from “the Coast” (p=0.01); the median diagnostic interval was 55 days in Nuuk vs. 95 days for patients from “the Coast” (p=0.04). Median hospital interval was similar for both groups (23 days vs 24 days; p=0.86). Women had a median primary care interval of 70 days vs. 15 days for men (p=0.06). Conclusions: Patients with CRC presented classic symptomatology of CRC. Primary care interval and diagnostic interval were significantly longer for patients from “the Coast” compared with Nuuk. Women tended to have longer primary care interval. A more standardised examination should be implemented and a national CRC screening programme should be considered to reduce the difference in diagnostic interval and ensure timely referral. |
format |
Article in Journal/Newspaper |
author |
Johan Tolstrup Rasmus Chemnitz Madsen Maria Vandborg Sneftrup Birgit Niclasen |
author_facet |
Johan Tolstrup Rasmus Chemnitz Madsen Maria Vandborg Sneftrup Birgit Niclasen |
author_sort |
Johan Tolstrup |
title |
Greenlandic patients with colorectal cancer: symptomatology, primary investigations and differences in diagnostic intervals between Nuuk and the rest of the country |
title_short |
Greenlandic patients with colorectal cancer: symptomatology, primary investigations and differences in diagnostic intervals between Nuuk and the rest of the country |
title_full |
Greenlandic patients with colorectal cancer: symptomatology, primary investigations and differences in diagnostic intervals between Nuuk and the rest of the country |
title_fullStr |
Greenlandic patients with colorectal cancer: symptomatology, primary investigations and differences in diagnostic intervals between Nuuk and the rest of the country |
title_full_unstemmed |
Greenlandic patients with colorectal cancer: symptomatology, primary investigations and differences in diagnostic intervals between Nuuk and the rest of the country |
title_sort |
greenlandic patients with colorectal cancer: symptomatology, primary investigations and differences in diagnostic intervals between nuuk and the rest of the country |
publisher |
Taylor & Francis Group |
publishDate |
2017 |
url |
https://doi.org/10.1080/22423982.2017.1344086 https://doaj.org/article/c237ac338f27471ea9bf479088551a1a |
long_lat |
ENVELOPE(-52.150,-52.150,68.717,68.717) |
geographic |
Arctic Greenland Nuuk |
geographic_facet |
Arctic Greenland Nuuk |
genre |
Arctic Circumpolar Health Greenland greenlandic International Journal of Circumpolar Health Nuuk |
genre_facet |
Arctic Circumpolar Health Greenland greenlandic International Journal of Circumpolar Health Nuuk |
op_source |
International Journal of Circumpolar Health, Vol 76, Iss 1 (2017) |
op_relation |
http://dx.doi.org/10.1080/22423982.2017.1344086 https://doaj.org/toc/2242-3982 2242-3982 doi:10.1080/22423982.2017.1344086 https://doaj.org/article/c237ac338f27471ea9bf479088551a1a |
op_doi |
https://doi.org/10.1080/22423982.2017.1344086 |
container_title |
International Journal of Circumpolar Health |
container_volume |
76 |
container_issue |
1 |
container_start_page |
1344086 |
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1766348639753469952 |