Prasad U, Pua K C
Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur.
Med J Malaysia. 2000 Jun;55(2):230-5.
One hundred consecutive newly diagnosed patients with nasopharyngeal carcinoma (NPC) since January 1994 were the subjects for studying various factors that contribute to the delay in the confirmation of the diagnosis. Seventy-nine of them were males and the peak age of incidence was the fifth decade. Ninety two percent were Chinese, 7% Malay and 1% Indian. Seventy six percent were agriculture workers or labourers with 66% having either no formal education (16%) or only primary level education (50%). In 50% of patients neck swelling was the first presenting symptom, 26% had nasal symptoms, 12% ear symptoms and 11% has symptoms due to intracranial extension of tumour. As many as 80% were at UICC Stage IV at the time of diagnosis. While the median delay, on the part of patients, in consulting a doctor was 2.5 days, the median delay on the part of the doctors to confirm the diagnosis of NPC was 127 days, the delays was particularly worse when the patients presented with ear symptoms (266 days) followed by those with neck swelling (94 days). For those patients who were required to undergo more than one nasopharyngoscopy and biopsy the median doctor's delay was 144 days. Since 82% of patient's had first consulted general practitioners, it is suggested that their level of awareness with regards to the diagnosis of NPC be significantly raised so that the delay on their part be greatly minimized.
1994年1月以来连续确诊的100例鼻咽癌（NPC）新发病例作为研究导致诊断延迟的各种因素的对象。其中79例为男性，发病高峰年龄为第五个十年。92%为华人，7%为马来人，1%为印度人。76%为农业工人或劳动者，66%未接受过正规教育（16%）或仅接受过小学教育（50%）。50%的患者首发症状为颈部肿胀，26%有鼻部症状，12%有耳部症状，11%有肿瘤颅内扩展引起的症状。多达80%的患者在诊断时处于UICC IV期。患者咨询医生的中位延迟时间为2.5天，而医生确诊NPC的中位延迟时间为127天，当患者出现耳部症状时延迟尤为严重（266天），其次是颈部肿胀的患者（94天）。对于那些需要进行多次鼻咽镜检查和活检的患者，医生的中位延迟时间为144天。由于82%的患者首先咨询了全科医生，建议显著提高他们对NPC诊断的认识水平，以便最大程度地减少他们的延迟。
