Department of Radiation Oncology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
Gynecol Oncol. 2012 Mar;124(3):395-8. doi: 10.1016/j.ygyno.2011.11.040. Epub 2011 Dec 1.
To determine the effect of socio-economic status (SES) on delayed access to medical treatment by Chinese cervical cancer patients who suffered from late rectal sequelae (LRS) after external beam radiation therapy (EBRT) and intracavitary brachytherapy.
Patients diagnosed with LRS were interviewed for their SES, factors including age, residing district, religion, marital status, income, education, insurance and patient delay (the time interval from the onset of symptoms to the first medical consultation) and other factors such as weight, symptom duration and disease stage at diagnosis.
One hundred and twenty nine patients were interviewed. Seventy-one patients (55%) sought medical treatment within three months after the first symptom being recognized and fifty-eight patients (45%) delayed their medical treatment over 3 months. The study shows that age ≥ 55 (OR=12.1; 95% CI: 3.3-43.9), lower education (OR=4.6; 95% CI: 2.0-10.4 for women with primary school education or illiterate), low annual household income (OR=2.3; 95% CI: 1.2-5.1) and widow/divorce (OR=0.1; 95% CI: 0.01-0.07) were the high risk factors for delayed reporting. Patients with bleeding or bleeding plus other symptoms (61.2%) were more likely to seek treatment within three months, compared to patients with other symptoms only (38.8%) (p=0.002). Additionally, delayed reporting was found to be significantly associated with the late stage of late rectal sequelae (LRS) (p=0.000) and the patients with 55 years or older (p=0.000).
Delayed reporting and late-stage presentation of late rectal sequelae are more prevalent among Chinese cervical cancer patients with 55 years or older, low education, poor marital status, or poor financial status. Effective social support and educational programs should be implemented to encourage these patients to seek medical treatment as soon as possible.
探讨社会经济地位（SES）对接受外照射放疗（EBRT）和腔内近距离放疗后发生晚期直肠后遗症（LRS）的中国宫颈癌患者延迟治疗的影响。
对诊断为 LRS 的患者进行 SES 访谈，包括年龄、居住地区、宗教信仰、婚姻状况、收入、教育程度、保险以及患者延迟就诊（从出现症状到首次就诊的时间间隔）等因素，同时还包括体重、症状持续时间和诊断时疾病分期等其他因素。
共访谈了 129 名患者。71 名患者（55%）在首次出现症状后 3 个月内就医，58 名患者（45%）延迟就诊超过 3 个月。研究表明，年龄≥55 岁（OR=12.1；95%CI：3.3-43.9）、教育程度低（女性小学及以下文化程度或文盲：OR=4.6；95%CI：2.0-10.4）、家庭年收入低（OR=2.3；95%CI：1.2-5.1）和丧偶/离异（OR=0.1；95%CI：0.01-0.07）是延迟报告的高危因素。有出血或出血伴其他症状的患者（61.2%）更有可能在 3 个月内就诊，而仅有其他症状的患者（38.8%）则更有可能延迟就诊（p=0.002）。此外，延迟报告与晚期 LRS （p=0.000）和 55 岁及以上患者（p=0.000）显著相关。
在中国，55 岁及以上、教育程度低、婚姻状况差或经济状况差的宫颈癌患者更有可能出现延迟报告和晚期 LRS。应实施有效的社会支持和教育计划，鼓励这些患者尽快就医。
