Department of Urology, Trinity College Dublin, Adelaide and Meath incorporating National Children's Hospital, Dublin, Ireland.
J Urol. 2011 Mar;185(3):876-80. doi: 10.1016/j.juro.2010.11.007. Epub 2011 Jan 15.
We examined the process and causes of diagnostic delay, defined as the interval from symptom onset to diagnosis, for testis (germ cell) cancer and the change with time. Diagnostic delay influences disease burden and may be subdivided into symptomatic interval, defined as symptom onset to first presentation, and diagnostic interval, defined as first presentation to diagnosis.
We performed a single center review of 100 consecutive cases. Diagnostic delay in weeks, and symptomatic and diagnostic intervals in days were calculated, and related factors were recorded. Previous reports by the senior author (JT) in the same health care system allowed the examination of change during 2 decades.
Mean±SD diagnostic delay was 12.5±17.4 weeks (median 6, range 1 to 104), a substantial decrease in the mean of 10 months reported by one of us (JT) in 1987. Mean symptomatic interval was 65.4±100.9 days (median 29, range 0 to 720). Mean diagnostic interval was 21.9±63.5 days (median 7, range 1 to 540). Symptomatic interval exceeded or was equal to diagnostic interval in 80 men.
This terminology allows detailed examination of the diagnostic process for testis cancer. Aberrant diagnostic delay for testis cancer is decreasing and is now dominated by patient dependent factors. Select cases suggest that physician error remains a factor in a minority.
我们研究了睾丸（生殖细胞）癌诊断延迟的过程和原因，将其定义为从症状出现到诊断的时间间隔，并探讨了其随时间的变化。诊断延迟会影响疾病负担，可进一步细分为症状间隔，即症状出现到首次就诊的时间，以及诊断间隔，即首次就诊到诊断的时间。
我们对 100 例连续病例进行了单中心回顾。计算了以周为单位的诊断延迟，以及以天为单位的症状间隔和诊断间隔，并记录了相关因素。我们的一位资深作者（JT）在同一医疗体系中的先前报告允许我们检查 20 年来的变化。
平均诊断延迟为 12.5±17.4 周（中位数 6，范围 1 至 104），比我们一位作者（JT）在 1987 年报告的平均值减少了 10 个月，这是一个显著的下降。平均症状间隔为 65.4±100.9 天（中位数 29，范围 0 至 720）。平均诊断间隔为 21.9±63.5 天（中位数 7，范围 1 至 540）。80 名男性的症状间隔超过或等于诊断间隔。
这种术语允许详细检查睾丸癌的诊断过程。睾丸癌的异常诊断延迟正在减少，现在主要受患者因素的影响。少数情况下，医生的错误仍然是一个因素。
