Delay in diagnosis

Summer 2011 

Laura Cooper, Macmillan Teenage and Young People Information Nurse, explains why late diagnosis is a real issue for young people with cancer.

Around 2,100 people between the ages of 13 and 24 are diagnosed with cancer every year in the UK and survival rates continue to lag behind those of childhood cancers.

 

Reasons for this include poor clinical trial accrual, aggressive tumour biology, poor adherence to treatment protocols and late diagnosis. All of these issues must be addressed, but delay in diagnosis is an important factor to look at.

Young people get cancer too

There’s a common misconception among the public and professionals that young people are immune from getting cancer because of their age. In fact, the tumours that this age group get, while rare, are often more aggressive than those in children and adults.

 

Delays in cancer diagnoses aren’t confined to this age group, but there is a lack of expectation from doctors that young people get cancer. The symptoms that an individual may present with are far more likely to be attributed to a more common cause, but cancer must not be excluded if symptoms persist.

 

Young people with cancer often present to their GP many times and over a long period of time before further tests are sought.

Assessing symptoms

Symptoms can be vague and misdiagnosis of sports injuries and hormonal imbalances are examples of the explanations given by doctors. Reassurances from professionals that these diagnoses are correct can be readily accepted by young people.

 

While a cancer diagnosis is rare in this age group, if the symptoms fail to improve, it’s important to remember that cancer may be a possibility. A delay in diagnosis can lead to family anguish, more advanced disease, and distrust of medical professionals by both the patient and family.

Taking responsibility

Young people also need to take responsibility for their own health to help shorten the time between presentation and diagnosis. There is resistance from young people to seek medical advice when symptoms appear and parents are less able to enforce visits to the doctor on their child in the teenage and young adult years.

 

Young people may fear the outcome of their symptoms and may not have the knowledge to recognise their symptoms as being potentially serious or life threatening.

What you can do

We must try to educate young people of the potential signs and symptoms of cancer and empower them to seek further advice. However, it’s important to balance increasing awareness and subjecting young people to unnecessary tests and procedures.

 

In places such as colleges and universities it may be beneficial to produce clear guidelines for referral of suspected cancers within the given age group. We must take young people seriously. If symptoms don’t improve after an initial diagnosis of a benign condition, further investigations should be carried out. We must do everything we can to reduce potentially fatal delays in cancer diagnoses and improve the survival rates of this unique patient group.

References

Albritton K and Eden T. REVIEW: Access to Care. Pediatric Blood & Cancer. 2008. 50; 1094–1098.

 

Eden T. Addressing delays in diagnosis. 2010. Teenage Cancer Trust Conference Presentation.

 

Gibson F, et al. Report to CLIC Sargent. 2003. Grinyer A. Young People Living With Cancer. 2007. Open University Press, Maidenhead

Related information

Sometimes it’s cancer is a DVD produced by jimmyteens.tv| It talks about some of the signs and symptoms of cancer in young people. I’m still me is a guide for young people living with cancer. You can order it for free at be.macmillan.org.uk|

More information

Email Laura|.