Specialized healthcare diagnostic events within one year preceding colorectal cancer diagnosis

Seppä K, Lappi-Heikkinen S, Johansson S, Malila N, Pitkäniemi J. SYÖPÄ 2023. Tilastoraportti Suomen syöpätilanteesta. Helsinki: Suomen Syöpäyhdistys; 2025. [Finnish]

Savijärvi S, Seppä K, Malila N, Pitkäniemi J, Heikkinen S. Trends of colorectal cancer incidence by education and socioeconomic status in Finland. Acta Oncol. 2019;58(11):1557–63.

https://doi.org/10.1080/0284186X.2019.1652340 DOI: https://doi.org/10.1080/0284186X.2019.1652340

Cardoso R, Guo F, Heisser T, Hackl M, Ihle P, De Schutter H, et al. Colorectal cancer incidence, mortality, and stage distribution in European countries in the colorectal cancer screening era: an international population-based study. Lancet Oncol. 2021;22(7):1002–13.

https://doi.org/10.1016/S1470-2045(21)00199-6 DOI: https://doi.org/10.1016/S1470-2045(21)00199-6

Engholm G, Lundberg FE, Kønig SM, Ólafsdóttir E, Johannesen TB, Pettersson D, et al. TNM stage in the Nordic Cancer Registries 2004–2016: registration and availability. Acta Oncol. 2024;63:303–12.

https://doi.org/10.2340/1651-226X.2024.35232 DOI: https://doi.org/10.2340/1651-226X.2024.35232

Koskenvuo L, Malila N, Pitkäniemi J, Miettinen J, Heikkinen S, Sallinen V. Sex differences in faecal occult blood test screening for colorectal cancer. Br J Surg. 2019;106(4):436–47.

https://doi.org/10.1002/bjs.11011 DOI: https://doi.org/10.1002/bjs.11011

Nilssen Y, Brustugun OT, Eriksen MT, Haug ES, Naume B, Møller B. Patient and tumour characteristics associated with inclusion in cancer patient pathways in Norway in 2015–2016. BMC Cancer. 2020;20(1):488.

https://doi.org/10.1186/s12885-020-06979-y DOI: https://doi.org/10.1186/s12885-020-06979-y

Hermiö E, Seppä K, Ryynänen H, Hirvonen E, Pylkkänen L, Järvelin J, et al. Use of health services one year before primary colorectal cancer. BMC Health Serv Res. 2023;23(1):279.

https://doi.org/10.1186/s12913-023-09298-7 DOI: https://doi.org/10.1186/s12913-023-09298-7

Kuiper JG, van Herk-Sukel MPP, Lemmens VEPP, Kuipers EJ, Herings RMC. A steep increase in healthcare seeking behaviour in the last months before colorectal cancer diagnosis. BMC Fam Pract. 2021;22(1):121.

https://doi.org/10.1186/s12875-021-01482-0 DOI: https://doi.org/10.1186/s12875-021-01482-0

Ahrensberg JM, Fenger-Grøn M, Vedsted P. Primary care use before cancer diagnosis in adolescents and young adults – a nationwide register study. PLoS One. 2016;11(5):e0155933.

https://doi.org/10.1371/journal.pone.0155933 DOI: https://doi.org/10.1371/journal.pone.0155933

Christensen KG, Fenger-Grøn M, Flarup KR, Vedsted P. Use of general practice, diagnostic investigations and hospital services before and after cancer diagnosis – a population-based nationwide registry study of 127,000 incident adult cancer patients. BMC Health Serv Res. 2012;12:224.

https://doi.org/10.1186/1472-6963-12-224 DOI: https://doi.org/10.1186/1472-6963-12-224

Hansen PL, Hjertholm P, Vedsted P. Increased diagnostic activity in general practice during the year preceding colorectal cancer diagnosis. Int J Cancer. 2015;137(3):615–24.

https://doi.org/10.1002/ijc.29418 DOI: https://doi.org/10.1002/ijc.29418

Rasmussen S, Haastrup PF, Balasubramaniam K, Elnegaard S, dePont Christensen R, Storsveen MM, et al. Predictive values of colorectal cancer alarm symptoms in the general population: a nationwide cohort study. Br J Cancer. 2019;120(6):595–600.

https://doi.org/10.1038/s41416-019-0385-x DOI: https://doi.org/10.1038/s41416-019-0385-x

Astin M, Griffin T, Neal RD, Rose P, Hamilton W. The diagnostic value of symptoms for colorectal cancer in primary care: a systematic review. Br J Gen Pract. 2011;61(586):e231–43.

https://doi.org/10.3399/bjgp11X572427 DOI: https://doi.org/10.3399/bjgp11X572427

World Health Organization. International statistical classification of diseases and related health problems, 10th revision. Volume 2: instruction manual [Internet]. 2016 [cited 2024 Jun 20]. Available from: https://icd.who.int/browse10/content/statichtml/icd10volume2_en_2016.pdf

Leinonen MK, Miettinen J, Heikkinen S, Pitkäniemi J, Malila N. Quality measures of the population-based Finnish Cancer Registry indicate sound data quality for solid malignant tumours. Eur J Cancer. 2017;77:31–9.

https://doi.org/10.1016/j.ejca.2017.02.017 DOI: https://doi.org/10.1016/j.ejca.2017.02.017

Pukkala E, Engholm G, Schmidt LKH, Storm H, Khan S, Lambe M, et al. Nordic Cancer Registries – an overview of their procedures and data comparability. Acta Oncol. 2018;57(4):440–55.

https://doi.org/10.1080/0284186X.2017.1407039 DOI: https://doi.org/10.1080/0284186X.2017.1407039

Terveyden ja hyvinvoinnin laitos. HILMO – Sosiaalihuollon ja terveydenhuollon hoitoilmoitus: Määrittelyt ja ohjeistus [Internet]. THL; 2014. [cited 2024 Sep 7] Available from: https://urn.fi/URN:ISBN:978-952-302-350-5 [Finnish]

Plummer M. rjags: Bayesian Graphical Models using MCMC [Internet]. 2025 [cited 2025 Jun 25]. Available from: https://cran.r-project.org/web/packages/rjags/index.html

R Foundation for Statistical Computing. The R project for statistical computing [Internet]. [cited 2025 Jun 25]. Available from: https://www.r-project.org/

Holtedahl K, Borgquist L, Donker GA, Buntinx F, Weller D, Campbell C, et al. Symptoms and signs of colorectal cancer, with differences between proximal and distal colon cancer: a prospective cohort study of diagnostic accuracy in primary care. BMC Fam Pract. 2021;22:148.

https://doi.org/10.1186/s12875-021-01452-6 DOI: https://doi.org/10.1186/s12875-021-01452-6

Alexiusdottir KK, Möller PH, Snaebjornsson P, Jonasson L, Olafsdottir EJ, Björnsson ES, et al. Association of symptoms of colon cancer patients with tumor location and TNM tumor stage. Scand J Gastroenterol. 2012;47(7):795–801.

https://doi.org/10.3109/00365521.2012.672589 DOI: https://doi.org/10.3109/00365521.2012.672589

Demb J, Kolb JM, Dounel J, Fritz CDL, Advani SM, Cao Y, et al. Red flag signs and symptoms for patients with early-onset colorectal cancer: a systematic review and meta-analysis. JAMA Netw Open. 2024;7(5):e2413157.

https://doi.org/10.1001/jamanetworkopen.2024.13157 DOI: https://doi.org/10.1001/jamanetworkopen.2024.13157

Danckert B, Falborg AZ, Christensen NL, Frederiksen H, Lyratzopoulos G, McPhail S, et al. Routes to diagnosis and the association with the prognosis in patients with cancer – a nationwide register-based cohort study in Denmark. Cancer Epidemiol. 2021;74:101983.

https://doi.org/10.1016/j.canep.2021.101983 DOI: https://doi.org/10.1016/j.canep.2021.101983

Wilt JK, Siminoff LA, Thomson MD. Pre-diagnosis symptoms, attributed causes, and healthcare seeking assets of younger colorectal cancer survivors. J Canc Educ. 2023;38(6):1932–8.

https://doi.org/10.1007/s13187-023-02363-z DOI: https://doi.org/10.1007/s13187-023-02363-z

Macdonald S, Blane D, Browne S, Conway E, Macleod U, May C, et al. Illness identity as an important component of candidacy: contrasting experiences of help-seeking and access to care in cancer and heart disease. Soc Sci Med. 2016;168:101–10.

https://doi.org/10.1016/j.socscimed.2016.08.022 DOI: https://doi.org/10.1016/j.socscimed.2016.08.022

Jensen LF, Pedersen AF, Andersen B, Fenger-Grøn M, Vedsted P. Distance to screening site and non-participation in screening for breast cancer: a population-based study. Public Health (Oxf). 2014;36(2):292–9.

https://doi.org/10.1093/pubmed/fdt068 DOI: https://doi.org/10.1093/pubmed/fdt068

Sund R. Quality of the Finnish Hospital Discharge Register: a systematic review. Scand J Public Health. 2012;40(6):505–15.

https://doi.org/10.1177/1403494812456637 DOI: https://doi.org/10.1177/1403494812456637

Sarkeala T, Färkkilä M, Anttila A, Hyöty M, Kairaluoma M, Rautio T, et al. Piloting gender-oriented colorectal cancer screening with a faecal immunochemical test: population-based registry study from Finland. BMJ Open. 2021;11:e046667.

https://doi.org/10.1136/bmjopen-2020-046667 DOI: https://doi.org/10.1136/bmjopen-2020-046667