Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Hong Kong Med J. 2010 Oct;16(5):373-7.
Delayed presentation is an important obstacle to improving cancer treatment outcomes. We aimed to study the magnitude of this problem in Hong Kong and the factors associated with delayed presentation of patients with symptomatic breast cancers.
Retrospective study using self-administered questionnaires.
Clinical Oncology Department in a regional public hospital in Hong Kong.
A total of 158 Chinese women with breast cancer referred to our hospital between October 2006 and December 2007 consented to participate in this study. Among these, 59 (37%) patients were referred after having surgery in private sector.
The mean total delay (from first symptom to treatment) was 22 weeks. The mean patient delay (from first symptom to first consultation) was 13 weeks, constituting the largest component (60%) of the total delay. After symptom onset, the delay exceeded 12 weeks for consulting a doctor in 29%, and for receipt of treatment in 52% of them. Low family income (<HK$5000 per month; P<0.001) and surgery in public hospitals (P=0.013) were both independent predictors of patient delay. Surgery in public hospitals (P=0.006) and low family income (P=0.005) were the only predictors of doctor/system delay and total delay, respectively.
Delayed presentation and treatment of symptomatic breast cancer remains an important issue in Hong Kong. Apart from socio-economic factors, limited access to public medical care was likely an important contributing factor in delays related to patients as well as to doctor/system.
延迟就诊是改善癌症治疗效果的一个重要障碍。本研究旨在探讨香港地区癌症患者延迟就诊的严重程度及其相关因素。
回顾性问卷调查研究。
香港一家地区公立医院的临床肿瘤科。
2006 年 10 月至 2007 年 12 月期间，我院共收治了 158 例女性乳腺癌患者，其中 59 例（37%）患者曾在私营医疗机构进行过手术。这 158 例患者均同意参加本研究。
平均总延误（从首发症状到治疗）为 22 周。平均患者延误（从首发症状到首次就诊）为 13 周，占总延误的 60%。症状出现后，有 29%的患者在 12 周以上才去看医生，有 52%的患者在 12 周以上才开始接受治疗。家庭收入低（<5000 港元/月；P<0.001）和在公立医院接受手术（P=0.013）是导致患者延误的独立预测因素。在公立医院接受手术（P=0.006）和家庭收入低（P=0.005）是导致医生/系统延误和总延误的唯一预测因素。
在香港，有症状的乳腺癌患者就诊和治疗仍存在延迟的问题。除社会经济因素外，公共医疗服务的可及性有限可能是导致患者和医生/系统延误的一个重要因素。
