Patient delay and stage of diagnosis among breast cancer patients in Germany -- a population based study.
Patient delay and stage of diagnosis among breast cancer patients in Germany -- a population based study.
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DOI：
10.1038/sj.bjc.6600209
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发表时间：
2002-04-08
影响因子：
8.8
通讯作者：
Brenner, H
中科院分区：
文献类型：
--
作者：
Arndt, V;Sturmer, T;Stegmaier, C;Ziegler, H;Dhom, G;Brenner, H
早期诊断是肿瘤学的一个原则，应该能够早期治疗，以期改善预后。在德国女性乳腺癌患者中进行的一项基于人群的研究中，检查了乳腺癌患者诊断延迟的程度和决定因素及其对疾病分期的影响。二百八十七名妇女，年龄在18至80岁，新诊断的浸润性症状性乳腺癌，接受了采访的诊断过程。患者延迟定义为从首次出现症状到首次咨询医生的时间。有症状患者的中位患者延迟时间为16天。在所有乳腺癌患者中，有18%的人在咨询医生之前等待了3个月以上。患者的长期延迟与年龄、良性乳腺病史、肥胖和健康行为指标相关，如不了解妇科医生的门诊护理和不参加一般健康筛查检查。对于低分化肿瘤，观察到患者延迟和诊断阶段之间存在很强的相关性。这些结果表明，可以确定延迟咨询的风险群体，如果所有有乳腺癌症状的患者在1个月内向医生就诊，则可以避免相当大比例的低分化乳腺癌病例的晚期诊断。英国癌症杂志（2002）86，1034-1040。DOI：10.1038/sj/bjc/6600209 www.bjcancer.com © 2002英国癌症研究中心
Early diagnosis is a tenet in oncology and should enable early treatment with the expectation of improved outcome. Extent and determinants of patient delay of diagnosis in breast cancer patients and its impact on stage of disease were examined in a population based study among female breast cancer patients in Germany. Two hundred and eighty-seven women, aged 18 to 80 years with newly diagnosed invasive symptomatic breast cancer, were interviewed with respect to the diagnostic process. Patient delay was defined as time from onset of first symptoms to first consultation of a doctor. Median patient delay was 16 days among symptomatic patients. Eighteen per cent of all breast cancer patients waited longer than 3 months before consulting a physician. Long patient delay was associated with old age, history of a benign mastopathy, obesity, and indices of health behaviour such as not knowing a gynaecologist for out-patient care and non-participation in general health screening examinations. A strong association between patient delay and stage at diagnosis was observed for poorly differentiated tumours. These results suggest that at risk groups for delaying consultation can be identified and that a substantial proportion of late stage diagnoses of poorly differentiated breast cancer cases could be avoided if all patients with breast cancer symptoms would present to a doctor within 1 month. British Journal of Cancer (2002) 86, 1034–1040. DOI: 10.1038/sj/bjc/6600209 www.bjcancer.com © 2002 Cancer Research UK