Ruiz-Torrejón A, Ramos-Monserrat M, Llobera-Cánaves J
Centro de Salud Emili Darder, Palma de Mallorca, Islas Baleares, Spain.
Aten Primaria. 2006 Jan;37(1):16-21. doi: 10.1157/13083935.
To describe the types of cancer identified in primary health care, their clinical presentation, management until diagnosis and delay in diagnosis.
Descriptive study based on secondary information from medical records.
Two urban health care centres in Mallorca, Spain.
Patients over 14 years old diagnosed with cancer between 1994 and 1998.
Age, sex, location of tumour, symptoms, role of family doctor, specialist referral, care environment, time from first symptom to diagnosis, and stage of tumour.
We identified 408 cancers. Mean age at diagnosis was 66.5 years (95% CI, 65.3-67.7); 237 (58.1%) were male. The most frequent tumours were colorectal, lung, prostate, breast and bladder, and the most common symptom was pain (33.1%; 95% CI, 28-38.3). The family doctor was involved in 63% of diagnoses (95% CI, 58.2-67.8). Mean delay from first symptom until diagnosis was 90 days, of which 26 were attributed to the patient and 55 to primary health care services. For colorectal, lung and prostate cancers, delay was shorter. The tumour was less advanced at diagnosis when family doctors were involved.
Family doctors are involved in the diagnosis of most cancers. In colorectal, lung and prostate cancers, their contribution could improve prognosis. More studies are needed to confirm these findings.
描述在初级卫生保健中确诊的癌症类型、临床表现、诊断前的管理以及诊断延迟情况。
基于病历二手信息的描述性研究。
西班牙马略卡岛的两个城市卫生保健中心。
1994年至1998年间确诊患癌的14岁以上患者。
年龄、性别、肿瘤位置、症状、家庭医生的作用、专科转诊、护理环境、从出现首个症状到确诊的时间以及肿瘤分期。
我们共确诊408例癌症。确诊时的平均年龄为66.5岁（95%可信区间，65.3 - 67.7）；男性237例（58.1%）。最常见的肿瘤为结直肠癌、肺癌、前列腺癌、乳腺癌和膀胱癌，最常见症状为疼痛（33.1%；95%可信区间，28 - 38.3）。63%的诊断有家庭医生参与（95%可信区间，58.2 - 67.8）。从出现首个症状到确诊的平均延迟时间为90天，其中26天归因于患者，55天归因于初级卫生保健服务。对于结直肠癌、肺癌和前列腺癌，延迟时间较短。家庭医生参与诊断时，肿瘤在确诊时分期较低。
家庭医生参与了大多数癌症的诊断。在结直肠癌、肺癌和前列腺癌方面，他们的贡献可能改善预后。需要更多研究来证实这些发现。
