Neal R D, Allgar V L
Department of General Practice, North Wales Clinical School, Wales College of Medicine, Cardiff University, Wrexham Technology Park, Wrexham LL13 7YP, Wales, UK.
Br J Cancer. 2005 Jun 6;92(11):1971-5. doi: 10.1038/sj.bjc.6602623.
This paper aims to explore the relationship between sociodemographic factors and the components of diagnostic delay (total, patient and primary care, referral, secondary care) for these six cancers (breast, colorectal, lung, ovarian, prostate, or non-Hodgkin's lymphoma). Secondary analysis of patient-reported data from the 'National Survey of NHS patients: Cancer' was undertaken (65 192 patients). Data were analysed using univariate analysis and Generalised Linear Modelling. With regard to total delay, the findings from the GLM showed that for colorectal cancer, the significant factors were marital status and age, for lung and ovarian cancer none of the factors were significant, for prostate cancer the only significant factor was social class, for non-Hodgkin's lymphoma the only significant factor was age, and for breast cancer the significant factors were marital status and ethnic group. Where associations between any of the component delays were found, the direction of the association was always in the same direction (female subjects had longer delays than male subjects, younger people had longer delays than older people, single and separated/divorced people had longer delays than married people, lower social class groups had longer delays than higher social class groups, and Black and south Asian people had longer delays than white people). These findings should influence the design of interventions aimed at reducing diagnostic delays with the aim of improving morbidity, mortality, and psychological outcomes through earlier stage diagnosis.
本文旨在探讨社会人口学因素与这六种癌症(乳腺癌、结直肠癌、肺癌、卵巢癌、前列腺癌或非霍奇金淋巴瘤)诊断延迟的组成部分(总延迟、患者及初级保健延迟、转诊延迟、二级保健延迟)之间的关系。对来自“英国国家医疗服务体系患者癌症调查”的患者报告数据进行了二次分析(65192名患者)。数据采用单变量分析和广义线性模型进行分析。关于总延迟,广义线性模型的结果显示,对于结直肠癌,显著因素是婚姻状况和年龄;对于肺癌和卵巢癌,没有显著因素;对于前列腺癌,唯一的显著因素是社会阶层;对于非霍奇金淋巴瘤,唯一的显著因素是年龄;对于乳腺癌,显著因素是婚姻状况和种族。在发现任何组成部分延迟之间存在关联的情况下,关联方向始终相同(女性患者的延迟比男性患者长,年轻人的延迟比老年人长,单身和分居/离婚者的延迟比已婚者长,社会阶层较低群体的延迟比社会阶层较高群体长,黑人和南亚人的延迟比白人长)。这些发现应会影响旨在减少诊断延迟的干预措施的设计,以期通过早期诊断改善发病率、死亡率和心理结果。