Understanding Diagnostic Episodes of Care in Patients with Early versus Late Cancers

Project Summary: Cancers are more curable when they are diagnosed early. Cancer screening tests can detect a cancer before symptoms are present, but many cancers do not have screening tests. Also, many patients with screenable cancers are actually diagnosed after symptoms start. We are interested in how cancer patients come to be diagnosed and which patients are more likely to be diagnosed early. Previous research: People who live in poorer neighbourhoods, recent immigrants, and people living in rural areas have a higher chance of being diagnosed late. Our previous work has also shown that the amount of time it takes to get a diagnosis can be longer than it should be, possibly affecting the chance of an early diagnosis. No one has looked carefully at this time period to understand why, for some people, the process is quick and for others it is not. Project description: We will study colorectal, breast, and head and neck cancers. We will use data from the Ontario Cancer Registry and cancer stage data linked to data about all the contacts that patients had with the healthcare system. We will describe and assess predictors of the length of time it takes to get a cancer diagnosis and what aspects of that process are associated with delay. We will look for factors that predict who is a risk of a late diagnosis and we will look for diagnostic paths that are more likely to lead to an early diagnosis. Impact and relevance statement: Our results could be used to better inform programs and guidelines on the cancer diagnostic process which could ultimately increase the number of people who survive. Our results could also help doctors know which of their patients is at risk of a late cancer diagnosis.