Dimitroulis G, Reade P, Wiesenfeld D
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne.
Eur J Cancer B Oral Oncol. 1992 Jul;28B(1):23-7. doi: 10.1016/0964-1955(92)90007-n.
Early diagnosis is an important factor affecting the prognosis of patients with oral cancer. Delays in diagnosis have been variously reported as being linked to the patient, the clinician or both. The purpose of this study was to investigate the referral patterns of patients with oral cancer by medical and dental practitioners, in order to assess the delays in diagnosis and to establish the reasons for these delays. 51 consecutive patients diagnosed with oral mucous membrane squamous cell carcinoma were retrospectively reviewed. In this study it was found that over one-third of the patients (38%) delayed seeking professional advice for more than 3 months after first being aware of the lesion. Initial delays in diagnosis of oral cancer was identified in one-third of the cases (17 patients), with antimicrobial medications prescribed and denture adjustments constituting the most frequently administered inappropriate therapy. General medical practitioners were more likely to encounter and refer patients with more advanced (T4) primary oral cancers than their dental colleagues. The findings of this study raise the concern that lack of patient awareness and inappropriate clinical management prevails in a community that should be better informed.
早期诊断是影响口腔癌患者预后的一个重要因素。据报道，诊断延迟与患者、临床医生或两者均有关联。本研究的目的是调查口腔癌患者经医学和牙科从业者的转诊模式，以评估诊断延迟情况并确定这些延迟的原因。对51例连续诊断为口腔黏膜鳞状细胞癌的患者进行了回顾性研究。本研究发现，超过三分之一的患者（38%）在首次意识到病变后超过3个月才延迟寻求专业建议。三分之一的病例（17例患者）出现了口腔癌的初始诊断延迟，其中使用抗菌药物和调整假牙是最常进行的不恰当治疗。与牙科同事相比，全科医生更有可能遇到并转诊患有更晚期（T4）原发性口腔癌的患者。本研究结果引发了人们的担忧，即在一个应该获得更多信息的社区中，患者意识缺乏和临床管理不当的情况普遍存在。
