Delays in starting treatment for bowel cancer, even by a few days, may substantially elevate the risk of the disease spreading, according to new research. Patients who wait more than a month and a half to begin treatment, typically involving surgery and chemotherapy, face a 55% higher risk of their cancer metastasizing compared to those treated immediately.
The study, conducted by researchers at the Indiana University School of Medicine, analyzed data from 11,927 U.S. adults over 40 with newly diagnosed bowel cancer that had not yet spread. The findings indicate that delays are particularly detrimental for patients requiring chemotherapy before surgery to shrink tumors.
When bowel cancer is detected at early stages, the five-year survival rate is 93%. However, this drops to 59% if the disease is diagnosed at later stages. The research suggests that the timing of treatment initiation is a critical factor.
Compared to patients who started treatment within three days of diagnosis, those experiencing delays of four to 46 days showed a 27% increased risk of metastasis. For delays of 47 days or more, the risk rose to 55%.
For patients undergoing neoadjuvant therapy (chemotherapy before surgery), waiting 68 days or longer to commence treatment was associated with nearly a threefold increase in the risk of metastasis.
The study's authors noted that the observed discrepancies are unlikely due to a specific biological timeline for treatment but rather may stem from patients falling through gaps in care or experiencing fragmented treatment following initial diagnosis. They emphasized the need to ensure prompt access to treatment to improve survival rates.
Bowel cancer, also known as colorectal cancer, is a significant health concern. In the U.S., it became the leading cause of cancer death among young people earlier this year. Recent estimates predict potential increases in mortality rates for individuals under 50 in the U.K.
In the U.K., national targets mandate that NHS patients begin cancer treatment within two months of diagnosis. However, current figures indicate this goal is met for approximately 70% of patients. The observed increase in bowel cancer cases among individuals under 50 in the U.K. has been described as an 'explosion,' with over 2,400 new cases annually, representing a 25% increase over the last decade.
Overall, bowel cancer is the fourth most common cancer in the U.K., with over 48,000 diagnoses and 17,700 deaths each year. It is also the second-leading cause of cancer death in Britain. Experts estimate that more than half of all bowel cancer cases are preventable through lifestyle modifications, including a healthy diet, weight management, regular exercise, and reduced alcohol and tobacco consumption.
Symptoms of bowel cancer can include changes in bowel habits, such as looser stools or constipation, increased frequency of bowel movements, and the presence of blood in the stool. Other potential warning signs include abdominal pain, bloating, unexplained weight loss, fatigue, and shortness of breath, which could indicate anemia.