Abstract
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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Acknowledgments
We would like to acknowledge the support of the Department of Surgery at University Hospitals Cleveland Medical Center and the University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES).
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KB, AO, SLS, and ES contributed to project design and drafting and revising the manuscript. Data collection and analysis was performed by KB. All authors have approved the final paper.
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Dr. Sharon L. Stein is a consultant for Merck Sharp and Medtronics.
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This manuscript was presented at Digestive Diseases Week May 2019, San Diego CA.
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Bingmer, K., Ofshteyn, A., Stein, S.L. et al. Delayed Diagnosis of Anal Cancer. J Gastrointest Surg 24, 212–217 (2020). https://doi.org/10.1007/s11605-019-04364-0
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DOI: https://doi.org/10.1007/s11605-019-04364-0