Cancer-related hospitalisations and "unknown' stage prostate cancer: a population-based record linkage study
Cancer-related hospitalisations and "unknown' stage prostate cancer: a population-based record linkage study
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DOI：
10.1136/bmjopen-2016-014259
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发表时间：
2017-01-01
期刊：
影响因子：
2.9
通讯作者：
O'Connell, Dianne Lesley
中科院分区：
文献类型：
--
作者：
Luo, Qingwei;Yu, Xue Qin;O'Connell, Dianne Lesley
目的：为了确定在澳大利亚最大的基于人群的癌症登记处中前列腺癌分期被记录为“未知”的原因，设计基于人群的前瞻性队列研究。几乎占全国总人口的三分之一。参与者新南威尔士州癌症登记处（NSWCR）记录了2001年诊断的前列腺癌病例-2009年与2000-2010年新南威尔士州入院患者数据收集（APDC）相关联。在这项研究中的所有患者有一个最低的12个月的后续行动，在医院的发病记录后，他们的诊断日期记录的NSWCR.Main结果措施发生率未知的“阶段前列腺癌和癌症特异性survival.Results的50597例前列腺癌病例中，39.9%被记录为具有未知的”阶段。在确诊后4个月内，77.2%没有医院报告的癌症诊断病例被记录为分期不详。在医院报告癌症诊断的患者中，7.6%接受根治性乳腺癌切除术（RP）的患者和34.0%接受RP以外手术的患者分期未知。在后一组中，与“未知”阶段相关的因素是居住在贫困地区（调整OR（aOR）范围：1.13 - 1.20），在私立医院就诊（aOR范围：1.25至2.13），只在白天入院接受护理（aOR=1.23，95% CI 1.11 - 1.36），或接受了除多次成像手术以外的手术（如仅活检，aOR范围：1.11 ~ 1.45）结论在临床分期未知的前列腺癌患者中，超过一半的患者在首次诊断后4个月内未被诊断为前列腺癌。我们确定了基于社会经济地位和设施类型的病例被记录为“未知”阶段的可能性的差异，这表明需要进一步调查与诊断和治疗途径有关的报告做法。
Objectives To identify reasons for prostate cancer stage being recorded as unknown' in Australia's largest population-based cancer registry.Design Prospective population-based cohort.Setting New South Wales (NSW) is the most populous state in Australia, with almost one third of the total national population.Participants NSW Cancer Registry (NSWCR) records for prostate cancer cases diagnosed in 2001-2009 were linked to the NSW Admitted Patient Data Collection (APDC) for 2000-2010. All patients in this study had a minimum of 12months follow-up in the hospital episode records after their date of diagnosis as recorded by the NSWCR.Main outcome measures Incidence of unknown' stage prostate cancer and cancer-specific survival.Results Of 50597 prostate cancer cases, 39.9% were recorded as having unknown' stage. Up to 4months after diagnosis, 77.2% of cases without a hospital-reported cancer diagnosis were recorded as having unknown' stage. Among those patients with a hospital-reported cancer diagnosis, stage was unknown' for 7.6% of cases who received a radical prostatectomy (RP) and for 34.0% of cases who had procedures other than RP. In the latter group, the factors that were related to having unknown' stage were living in disadvantaged areas (adjusted OR (aOR) range: 1.13 to 1.20), attending a private hospital (aOR range: 1.25 to 2.13), having day-only admission for care (aOR=1.23, 95% CI 1.11 to 1.36), or having procedures other than multiple procedures with imaging (eg, biopsy only, aOR range: 1.11 to 1.45).Conclusions Over half of unknown' stage prostate cancer cases did not have a hospital-reported prostate cancer diagnosis within the 4months after initial diagnosis. We identified differences in the likelihood of cases being recorded as unknown' stage based on socioeconomic status and facility type, which suggests that further investigation of reporting practices in relation to diagnostic and treatment pathways is required.