Cervical cancer diagnosis and treatment delays in the developing world: Evidence from a hospital-based study in Zambia.
Cervical cancer diagnosis and treatment delays in the developing world: Evidence from a hospital-based study in Zambia.
复制标题
DOI：
10.1016/j.gore.2021.100784
复制
发表时间：
2021-08
影响因子：
1.2
通讯作者：
Kalinda C
中科院分区：
文献类型：
--
作者：
Mumba JM;Kasonka L;Owiti OB;Andrew J;Lubeya MK;Lukama L;Kasempa C;Msadabwe SC;Kalinda C
在赞比亚，开始治疗宫颈癌的时间很长。公立医院的诊断和转诊周转时间更长。需要手术的宫颈癌患者开始治疗的延迟时间最长。需要进一步研究TT对宫颈癌患者生存的影响。加快对所有疑似宫颈癌病例的诊断程序，对于努力改善该疾病的临床结果仍然至关重要。然而，在赞比亚等一些发展中国家，缺乏评估影响诊断和治疗周转时间（达特）的因素以及对高质量癌症护理至关重要的其他指标的数据。我们在癌症医院（CDH）对2014年1月至2018年12月期间在该机构就诊的宫颈癌病例进行了一项回顾性医院研究。使用描述性统计量总结人口统计学特征，同时使用负二项分布的广义线性模型评估总体达特的决定因素。我们的研究包括2121例患者病例档案。中位年龄为49岁（IQR：±17），大多数患者（n = 634，31%）年龄在41 - 50岁之间。国际妇产科联合会（FIGO）癌症II期（n = 941，48%）最常见，而IV期（n = 103，5.2%）最少。公共实验室的平均诊断达特是私人实验室的1.48倍（95%CI：1.21-1.81）。此外，转诊延迟为55天（IQR：24-152），总体达特（oTAT）为110天（IQR：62-204）。患者年龄、HIV感染状况、癌症分期和组织学亚型对oTAT无影响，而婚姻状况对oTAT有影响。观察到的较长oTAT可能会增加宫颈癌患者的不可逆不良健康结局。需要通过增加卫生支出，特别是公共卫生设施的支出，改善赞比亚的癌症护理。
Time to treatment initiation for cervical cancer in Zambia is long. Public hospitals have longer diagnostic and referral turnaround time. Cervical cancer patients indicated for surgery have the longest delays to treatment initiation. Further study into TT's impact on survival of cervical cancer patients is needed. Expedited diagnostic processes for all suspected cervical cancer cases remain essential in the effort to improve clinical outcomes of the disease. However, in some developing countries like Zambia, there is paucity of data that assesses factors influencing diagnostic and treatment turnaround time (TAT) and other metrics vital for quality cancer care. We conducted a retrospective hospital-based study at the Cancer Diseases Hospital (CDH) for cervical cancer cases presenting to the facility between January 2014 and December 2018. Descriptive statistics were used to summarize demographic characteristics while a generalized linear model of the negative binomial was used to assess determinants of overall TAT. Our study included 2121 patient case files. The median age was 49 years (IQR: ±17) and most patients (n = 634, 31%) were aged between 41 and 50 years. The International Federation of Gynaecology and Obstetrics (FIGO) Cancer stage II (n = 941, 48%) was the most prevalent while stage IV (n = 103, 5.2%) was the least. The average diagnostic TAT in public laboratories was 1.48 (95%CI: 1.21–1.81) times longer than in private laboratories. Furthermore, referral delay was 55 days (IQR: 24–152) and the overall TAT (oTAT) was 110 days (IQR: 62–204). The age of the patient, HIV status, stage of cancer and histological subtype did not influence oTAT while marital status influenced oTAT. The observed longer oTAT may increase irreversible adverse health outcomes among cervical cancer patients. There is a need to improve cancer care in Zambia through improved health expenditure especially in public health facilities.
登录
查看更多内容
影响因子：
34.3
作者：
Arbyn, Marc;Weiderpass, Elisabete;Bray, Freddie
通讯作者：
Bray, Freddie
影响因子：
9.2
作者：
Li, Haiyu;Chi, Xiangbo;Chen, Yaokai
通讯作者：
Chen, Yaokai
影响因子：
3.5
作者：
Eifel, Patricia J.
通讯作者：
Eifel, Patricia J.
DOI：
10.1007/s00464-020-07499-3
发表时间：
2021-03
期刊：
Surgical endoscopy
影响因子：
--
作者：
Barsom EZ;Jansen M;Tanis PJ;van de Ven AWH;Blussé van Oud-Alblas M;Buskens CJ;Bemelman WA;Schijven MP
通讯作者：
Schijven MP
影响因子：
8.8
作者：
Jedy-Agba, Elima;Joko, Walburga Yvonne;Parkin, Donald Maxwell
通讯作者：
Parkin, Donald Maxwell