Time intervals from first symptom to treatment of cancer: a cohort study of 2,212 newly diagnosed cancer patients.
Time intervals from first symptom to treatment of cancer: a cohort study of 2,212 newly diagnosed cancer patients.
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DOI：
10.1186/1472-6963-11-284
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发表时间：
2011-10-25
影响因子：
2.8
通讯作者：
Olesen F
中科院分区：
文献类型：
--
作者：
Hansen RP;Vedsted P;Sokolowski I;Søndergaard J;Olesen F
癌症诊断的延误可能会使预后恶化。本研究的目的是探讨患者，全科医生（GP）和系统相关的延迟从第一次癌症症状的诊断和治疗的间隔，并分析延迟的程度不同的癌症类型。2004-05年在丹麦奥胡斯县（640，000名居民）进行的基于人群的队列研究。数据来自行政登记处和全科医生完成的问卷调查，涉及1年内新诊断的2,212名癌症患者。中位延迟（以天为单位）和四分位间隔（IQI）是主要的结局指标。中位总延迟时间为98天（IQI 57-168）。大部分总延迟源于患者（中位数21天（7-56））和系统延迟（中位数55天（32-93））。中位GP延迟为0（0-2）天。卵巢癌（中位数60天（45-112））和乳腺癌（中位数65天（39-106））患者的总延迟时间最短，前列腺癌（中位数130天（89-254））和膀胱癌（中位数134天（93-181））患者的总延迟时间最长。系统延迟占癌症患者经历的总延迟的相当大的一部分。这表明，如果可能的话，需要缩短临床路径。长期的病人延误要求研究病人对癌症的认识。对于所有延迟成分，应特别关注时间间隔最长的第四个四分位数患者，我们需要研究诊断检查过程的质量。我们发现不同类型癌症的延迟差异很大。因此，改进应针对广大人群以及与个别癌症类型及其症状相关的特定需求。
Delay in diagnosis of cancer may worsen prognosis. The aim of this study is to explore patient-, general practitioner (GP)- and system-related delay in the interval from first cancer symptom to diagnosis and treatment, and to analyse the extent to which delays differ by cancer type. Population-based cohort study conducted in 2004-05 in the County of Aarhus, Denmark (640,000 inhabitants). Data were collected from administrative registries and questionnaires completed by GPs on 2,212 cancer patients newly diagnosed during a 1-year period. Median delay (in days) with interquartile interval (IQI) was the main outcome measure. Median total delay was 98 days (IQI 57-168). Most of the total delay stemmed from patient (median 21 days (7-56)) and system delay (median 55 days (32-93)). Median GP delay was 0 (0-2) days. Total delay was shortest among patients with ovarian (median 60 days (45-112)) and breast cancer (median 65 days (39-106)) and longest among patients with prostate (median 130 days (89-254)) and bladder cancer (median 134 days (93-181)). System delay accounted for a substantial part of the total delay experienced by cancer patients. This points to a need for shortening clinical pathways if possible. A long patient delay calls for research into patient awareness of cancer. For all delay components, special focus should be given to the 4th quartile of patients with the longest time intervals and we need research into the quality of the diagnostic work-up process. We found large variations in delay for different types of cancer. Improvements should therefore target both the population at large and the specific needs associated with individual cancer types and their symptoms.