Time to Myeloma Diagnosis: Room for Improvement
Posted: Wednesday, August 1, 2018
Certain patients with multiple myeloma tend to experience lengthy diagnostic intervals, in some cases more than 8 months, according to the findings of a systematic review and meta-analysis published in BMJ Open. Ann Van den Bruel, MD, PhD, of the Nuffield Department of Primary Care Health Sciences, University of Oxford, UK, and colleagues suggest the need for “meaningful reductions in the time to diagnosis,” which may improve patient outcomes.
Nine studies, most of which were retrospective, were included in the study: one from the United States, six from the UK, one from Hungary, and one from Israel. The following intervals were quantified in the path to diagnosis: onset of first myeloma-related symptom, date of first presentation to primary care, date of first referral to specialist, and date of myeloma diagnosis.
Dr. Van den Bruel and colleagues found that the median patient interval (first symptom to the first presentation) was 26.3 days, and the primary care interval (first presentation to first referral) was 21.6 days. They also reported a diagnostic interval (first presentation to diagnosis) of 108.6 days and a time to diagnosis (first symptom to diagnosis) of 163 days. “Our results show that patients with myeloma experience symptoms for a median of approximately 1 month before seeking help, and 25% of patients wait for more than 3 months (98 days),” they added.
The investigators concluded: “Future studies should estimate the duration of primary and referral to diagnosis intervals and investigate the impact of one setting on the other, as in most cases the type and severity of symptoms will determine the specialty and urgency of referral.”