Lung cancer referral patterns in the former Yorkshire region of the UK.
Lung cancer referral patterns in the former Yorkshire region of the UK.
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DOI：
10.1038/sj.bjc.6600029
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发表时间：
2002-01-07
影响因子：
8.8
通讯作者：
Crawford, S M
中科院分区：
文献类型：
--
作者：
Melling, P P;Hatfield, A C;Muers, M F;Peake, M D;Storer, C J;Round, C E;Haward, R A;Crawford, S M
这项研究的目的是找出肺癌指南假定的转诊患者的比例，不同的转诊路径是否会导致不同的管理，以及在转诊和治疗之间的建议时间间隔内，有多大比例的患者被转诊。从1993年约克郡癌症登记处登记的400例肺癌病例中随机抽取样本进行个案分析。分析介绍方式、首次转诊的特殊性、专科医生的治疗、转诊路径关键点的时间间隔。共有362份(90.5%)病例记录可供查阅。不到一半的肺癌患者(173，47.8%)因胸部X光诊断为肺癌而到医院就诊。41人(11.3%)是自行转诊到急症室，其余的人是通过其他途径(主要是全科医生)转诊到其他途径而没有被诊断为肺癌的。最初没有肺癌诊断的患者接受专科治疗(62% ： 96%)、组织学确诊(57.1% ： 80.3%)或接受手术或根治性放射治疗(6.9% ： 13.9%)的可能性较小。在所有362名患者中，9%的人没有得到专家的意见。全科医生转介的疑似肺癌的全科医生转介的患者中，有80%在两周内到医院就诊。在接受积极治疗的患者中，只有32.4%的患者在临床诊断或首次就诊后8周内得到治疗。到医院就诊的肺癌患者没有可疑的CXR，不太可能得到专科治疗、癌症的组织学确认，并且积极治疗的比率较低(手术、任何放射治疗或化疗)。《英国癌症杂志》(2002)86，36-42。DOI：10.1038/sj/bjc/6600029 www.bjancer.com？2002年癌症研究活动
The purpose of this study was to find out what proportion of patients are referred as lung cancer guidelines assume, whether different referral pathways result in different management and what proportion of patients are seen within recommended time intervals between referral and treatment. A randomly selected sample of 400 lung cancer cases registered with the former Yorkshire Cancer Registry database in 1993 was selected for casenote analysis. Mode of presentation, speciality of initial referral, treatment by specialist, time intervals for key points in the referral pathways were analyzed. A total of 362 (90.5%) of case-notes were available. Less than half of lung cancer patients (173, 47.8%) presented to hospital with a chest X-ray diagnosis of lung cancer. Forty-one (11.3%) presented as self-referrals to Accident and Emergency and the remainder were referred without a diagnosis of lung cancer by other routes, mainly via GPs. Patients who did not present initially with a lung cancer diagnosis were less likely to receive specialist care (62% : 96%), or have their diagnosis histologically confirmed (57.1% : 80.3%) or receive surgery or radical radiotherapy (6.9% : 13.9%). Nine per cent of all 362 patients did not receive a specialist opinion. Eighty per cent of patients referred by a GP with CXR suspected lung cancer were seen at hospital within 2 weeks. Only 32.4% of those receiving active treatment were treated within 8 weeks of clinical diagnosis or first hospital visit. Lung cancer patients presenting to hospital without a suspicious CXR are less likely to have specialist care, histological confirmation of their cancer and have lower rates of active treatment (surgery, any radiotherapy or chemotherapy). British Journal of Cancer (2002) 86, 36–42. DOI: 10.1038/sj/bjc/6600029 www.bjcancer.com © 2002 The Cancer Research Campaign