Multimorbidity is the norm of modern medicine. We know that multimorbidity affects healthcare use and outcomes,1 but we don’t know how the presence of pre-existing conditions can influence the diagnosis of new illness. Cancer typically affects older patients, and presents with symptoms of relatively low specificity that are shared between different conditions. Timely diagnosis is important,2,3 but missed or delayed diagnoses are common.4 Might the presence of chronic conditions help us understand why the diagnosis of patients with symptomatic-but-as-yet-undiagnosed cancer is delayed? Carney et al, in this issue of the BJGP, shed light on this complex question in the context of the diagnosis of bladder cancer.5
MECHANISMS BY WHICH COMORBIDITY MAY INFLUENCE THE DIAGNOSIS OF CANCER
Pre-existing chronic conditions may act as ‘competing demands’ that prevent the investigation of new presenting symptoms or offer ‘alternative explanations’ for them.6,7 For cancers of specific organs or systems, different morbidities can be categorised into those with unrelated symptomatology and those with …