Table 1 Main delay factors and assessment of evidence
No. of studies (subjects) | Supported (studies) | Not supported (studies) | No impact (studies) | Overall assessment /conclusion | |
|---|---|---|---|---|---|
Increases patient delay | |||||
Non-recognition of symptom seriousness | 9 (1840) | 2S, 3M, 4I | — | — | Increases delay |
Cancer site – stomach | 2 (713) | 1S, 1M | — | — | Increases delay |
Lower socio-economic status | 4 (979) | 2S, 1M | — | 1M | Increases delay |
Comorbidity | 2 (400) | — | 2S | — | Reduces delay |
First presenting to hospital | 2 (266) | — | 2S | — | Reduces delay |
Male sex | 5 (797) | 1I | 1S | 1S, 2M | No impact on delay |
Fear | 3 (1271)a | 2S, 1M | 2S | — | Inconclusive |
Experiencing pain | 7 (1169) | 1S, 1M, 1I | 1S, 3M | — | Inconclusive |
Older age | 7 (800) | 1S, 1M | 1S, 2M | 1S, 1M | Inconclusive |
Lower education | 2 (400) | 1S | 1S | — | Inconclusive |
Family history | 3 (777) | 1S | 1S | 1S | Inconclusive |
Increases practitioner delay | |||||
Initial misdiagnosis | 6 (3556) | 2M, 4I | — | — | Increases delay |
Acid suppression treatment | 3 (316) | 1S, 2M | — | — | Increases delay |
Inappropriate/inaccurate tests | 3 (226) | 1S, 2M | — | — | Increases delay |
Previous negative test result | 2 (94) | 1S, 1M | — | — | Increases delay |
Cancer site – oesophagus | 2 (1580) | 1M, 1I | — | — | Increases delay |
Female patient | 2 (1215) | 1S, 1M | — | — | Increases delay |
Older patient age | 1 (83) | — | 1M | — | Reduces delay |
Lower patient socio-economic status | 1 (83) | — | 1M | — | Reduces delay |
Use of referral guidelines | 1 (90) | — | 1S | — | Reduces delay |
Frequent patient attendance | 2 (265) | 1I | — | 1M | Inconclusive |
Comorbidity | 2 (267) | 1S | 1S | — | Inconclusive |
Use of rapid access endoscopy | 2 (821) | 1S | 1I | — | Inconclusive |
