Alarm Symptoms Often Do Not Result in Timely Diagnosis

Many evaluated for hematuria, hemoptysis, other conditions lack definite diagnoses after three years

22 aug 2009-- Many patients who present with certain alarm symptoms, including hematuria and rectal bleeding, do not receive a diagnosis in a reasonable amount of time, according to a study published online Aug. 13 in BMJ.

Roger Jones, M.D., of the King's College London School of Medicine, and colleagues tracked 762,325 patients aged 15 years and older who presented to one of 128 general practitioner sites in the United Kingdom with their first episodes of hematuria, hemoptysis, dysphagia or rectal bleeding from 1994 to 2000.

The researchers found that the proportions of patients who received a cancer or non-cancer diagnosis within 90 days were 17.5 percent of women and 18.3 percent of men who had presented with hematuria, 25.7 and 24 percent for hemoptysis, 17.2 and 22.6 percent for dysphagia, and 14.5 and 16.7 percent for rectal bleeding. After three years, more than three-fourths of patients presenting with rectal bleeding did not have a definite diagnosis. The figures were comparable for dysphagia (67 percent), hematuria (64 percent), and hemoptysis (46 percent). The authors estimated that for every four to seven patients evaluated for these four conditions, relevant diagnoses will be identified in one of them within 90 days.

"We believe that these data provide additional information to help clinicians manage patients presenting with symptoms suggestive of serious disease," Jones and colleagues conclude.

Abstract
Full Text