Delays in the diagnosis of six cancers:: analysis of data from the National Survey of NHS Patients:: Cancer
Delays in the diagnosis of six cancers:: analysis of data from the National Survey of NHS Patients:: Cancer
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DOI：
10.1038/sj.bjc.6602587
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发表时间：
2005-06-06
影响因子：
8.8
通讯作者：
Neal, RD
中科院分区：
文献类型：
--
作者：
Allgar, VL;Neal, RD
本文的目的是描述和比较六种癌症（乳腺癌、结肠直肠癌、肺癌、卵巢癌、前列腺癌和非霍奇金淋巴瘤）的诊断延迟（患者、初级保健、转诊、二级保健）的组成部分，并比较在诊断前看全科医生的患者和没有看全科医生的患者的延迟。对全国NHS患者调查：癌症（65192例）进行二次数据分析。乳腺癌患者总延迟时间最短（平均55.2天），其次是肺癌（88.5天）、卵巢癌（90.3天）、非霍奇金淋巴瘤（102.8天）、结直肠癌（125.7天）和前列腺癌（148.5天）。延迟的所有组成部分的趋势都是相似的。与病人和初级保健延误相比，转诊延误和二级保健延误要短得多。在诊断前看全科医生的患者比没有看全科医生的患者总的诊断延迟时间要长得多。在六种癌症中，延迟的所有组成部分都有显著差异。减少诊断延误的目的是增加早期癌症的比例可能会提高英国的癌症存活率，英国比其他大多数欧洲国家都要贫穷。需要制定旨在减少患者和初级保健延误的干预措施，并评估其对诊断阶段和心理困扰的影响。
The aim of this paper is to describe and compare components of diagnostic delay ( patient, primary care, referral, secondary care) for six cancers ( breast, colorectal, lung, ovarian, prostate and non-Hodgkin's lymphoma), and to compare delays in patients who saw their GP prior to diagnosis with those who did not. Secondary data analysis of The National Survey of NHS Patients: Cancer was undertaken ( 65 192 patients). Breast cancer patients experienced the shortest total delays ( mean 55.2 days), followed by lung (88.5), ovarian (90.3), non-Hodgkin's lymphoma (102.8), colorectal (125.7) and prostate (148.5). Trends were similar for all components of delay. Compared with patient and primary care delays, referral delays and secondary care delays were much shorter. Patients who saw their GP prior to diagnosis experienced considerably longer total diagnostic delays than those who did not. There were significant differences in all components of delay between the six cancers. Reducing diagnostic delays with the intention of increasing the proportion of early stage cancers may improve cancer survival in the UK, which is poorer than most other European countries. Interventions aimed at reducing patient and primary care delays need to be developed and their effect on diagnostic stage and psychological distress evaluated.