Onizawa Kojiro, Nishihara Kazunari, Yamagata Kenji, Yusa Hiroshi, Yanagawa Toru, Yoshida Hiroshi
Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan.
Oral Oncol. 2003 Dec;39(8):781-8. doi: 10.1016/s1368-8375(03)00075-7.
Shortening the diagnostic delay from the onset of symptoms to the final diagnosis leads to early cancer detection and a reduced incidence of advanced cases. To analyze factors contributing to delays in the diagnosis of oral cancer, information was collected from the medical charts of 152 consecutive patients with oral squamous cell carcinoma, and factors associated with diagnostic delay were examined retrospectively. No characteristic was significantly associated with delay caused by patients. Referral by a non-initial professional, initial visit to a dentist, T1 cancer, and the presence of an ulcerative lesion were significantly associated with delay caused by the initial professionals. Patients with N0 were significantly associated with diagnostic delay caused by the final professional. These results re-emphasize the important role of the initial professional, particularly the dentist, and the diagnostic difficulty posed by ulcerative lesions and small-sized or early-stage oral cancer.
缩短从症状出现到最终诊断的诊断延迟时间可实现癌症的早期发现，并降低晚期病例的发生率。为分析导致口腔癌诊断延迟的因素，我们从152例连续的口腔鳞状细胞癌患者的病历中收集信息，并对与诊断延迟相关的因素进行回顾性研究。没有特征与患者导致的延迟显著相关。由非首诊专业人员转诊、首次就诊于牙医、T1期癌症以及存在溃疡性病变与首诊专业人员导致的延迟显著相关。N0期患者与最终专业人员导致的诊断延迟显著相关。这些结果再次强调了首诊专业人员，尤其是牙医的重要作用，以及溃疡性病变和小尺寸或早期口腔癌带来的诊断困难。
