Dang-Tan Tam, Trottier Helen, Mery Leslie S, Morrison Howard I, Barr Ronald D, Greenberg Mark L, Franco Eduardo L
Departments of Oncology and Epidemiology, McGill University, Montreal, Canada.
Pediatr Blood Cancer. 2008 Oct;51(4):468-74. doi: 10.1002/pbc.21600.
Few studies have investigated delays in diagnosis and treatment among children and adolescents with cancer, especially from the perspective of an entire country. Detailed understanding of delays along the continuum of cancer patient care is important in order to establish appropriate benchmarks for timely oncological care. Our objective was to characterise the different components of delay in 2,896 Canadian children and adolescents (aged 0-19 years) with cancer that were enrolled in the Treatment and Outcome Surveillance component of the Canadian Childhood Cancer Surveillance and Control Program from 1995 to 2000.
We examined median and standardised means concerning the distribution of delay times across categories of pertinent variables and over time. The word "delay" was used simply to represent a time interval, measured in days, without implying whether this interval exceeded a particular threshold of clinical acceptability.
The median times (and inter-quartile ranges) for patient, diagnosis and healthcare system delays for all cancers were 9 (1-31), 30 (13-69) and 12 (4-35) days, respectively. The median total delay was 34 (16-76) days.
Patient and referral delays were the longest time segments influencing timely diagnosis. Differences in delays were observed across age groups, cancer types and geographical regions. There was a significant trend for decreasing delays to diagnosis and treatment.
很少有研究调查癌症儿童和青少年诊断及治疗的延迟情况，尤其是从整个国家的角度。深入了解癌症患者护理连续过程中的延迟情况对于建立及时肿瘤护理的适当基准非常重要。我们的目标是描述1995年至2000年纳入加拿大儿童癌症监测与控制计划治疗与结果监测部分的2896名加拿大癌症儿童和青少年（0至19岁）延迟的不同组成部分。
我们检查了关于延迟时间在相关变量类别间及随时间分布的中位数和标准化均值。“延迟”一词仅用于表示以天为单位测量的时间间隔，并不意味着该间隔是否超过临床可接受的特定阈值。
所有癌症患者、诊断和医疗系统延迟的中位数时间（及四分位间距）分别为9天（1至31天）、30天（13至69天）和12天（4至35天）。总延迟的中位数为34天（16至76天）。
患者和转诊延迟是影响及时诊断的最长时间段。不同年龄组、癌症类型和地理区域的延迟存在差异。诊断和治疗延迟呈显著下降趋势。
