Language
English
Publication Date
5-1-2025
Journal
Diagnosis
DOI
10.1515/dx-2024-0113
PMID
39422050
PMCID
PMC12105846
PubMedCentral® Posted Date
10-18-2024
PubMedCentral® Full Text Version
Post-print
Abstract
Cancer will affect more than one in three U.S. residents in their lifetime, and although the diagnosis will be made efficiently in most of these cases, roughly one in five patients will experience a delayed or missed diagnosis. In this integrative review, we focus on missed opportunities in the diagnosis of breast, lung, and colorectal cancer in the ambulatory care environment. From a review of 493 publications, we summarize the current evidence regarding the contributing factors to missed or delayed cancer diagnosis in ambulatory care, as well as evidence to support possible strategies for intervention. Cancer diagnoses are made after follow-up of a positive screening test or an incidental finding, or most commonly, by following up and clarifying non-specific initial presentations to primary care. Breakdowns and delays are unacceptably common in each of these pathways, representing failures to follow-up on abnormal test results, incidental findings, non-specific symptoms, or consults. Interventions aimed at 'closing the loop' represent an opportunity to improve the timeliness of cancer diagnosis and reduce the harm from diagnostic errors. Improving patient engagement, using 'safety netting,' and taking advantage of the functionality offered through health information technology are all viable options to address these problems.
Keywords
Humans, Delayed Diagnosis, Neoplasms, Early Detection of Cancer, Ambulatory Care, Diagnostic Errors, Missed Diagnosis, cancer diagnosis, missed diagnosis, diagnostic errors, incidental findings, patient engagement, referral management
Published Open-Access
yes
Recommended Citation
Graber, Mark L; Winters, Bradford D; Matin, Roni; et al., "Interventions To Improve Timely Cancer Diagnosis: An Integrative Review" (2025). Faculty and Staff Publications. 4453.
https://digitalcommons.library.tmc.edu/baylor_docs/4453