Factors influencing delays in MPN presentation and diagnosis: A cross-sectional study

Recognition of cancer at an early stage is critical for improving patient outcomes. Delayed diagnosis is common in patients with MPN due to their rarity and the broad symptom profile of hematological malignancies, increasing the risk of prediagnostic thromboembolic events and other complications. A clear understanding of the barriers to presentation and diagnosis is required. 

To determine the barriers to early diagnosis of MPN, Tarburn et al. conducted an online, cross-sectional study of 620 patients with MPN (ET, n = 324; PV, n = 235; primary MF, n = 43; other subtypes, n = 18) in the UK and the Republic of Ireland. The study examined symptoms and factors that influenced delays in patient presentation, using adjusted odds ratios (aORs) to investigate the relationship between these factors and delays in GP referral. Findings were published in the British Journal of General Practice.¹ 

Key learnings

Patient factors significantly associated with delayed presentation included attributing symptoms to ageing (aOR, 1.92; 95% CI, 1.19–3.11) and not wanting to burden their GP (aOR, 2.04; 95% CI, 1.24–3.39).  

Most patients (80.2%) reported symptomatic presentation. Symptoms most commonly associated with delayed patient presentation included pruritus (aOR, 1.89; 95% CI, 1.19–3.01), headaches (aOR, 1.86; 95% CI, 1.13–2.82), and concentration difficulties (aOR, 1.75; 95% CI, 1.12–2.76). 

Patients reporting >3 signs of hematological cancer were more likely to experience a GP delay (from initial presentation to referral) vs those reporting ≤1 sign (aOR, 3.26; 95% CI, 1.75–6.29). Lack of relational continuity of GP care was significantly associated with GP delay (aOR, 3.41; 95% CI, 1.65–7.28). 

Challenging preconceptions about ageing, encouraging timely GP communication, and improving relational continuity of GP care could reduce diagnostic delays and potentially fatal disease complications. Improved awareness of the consequences of late diagnosis in the primary care setting is vital to improving patient outcomes.