Viertel Centre for Research in Cancer Control, Cancer Council Queensland, PO Box 201, Fortitude Valley, QLD, 4006, Australia.
Cancer Causes Control. 2012 Apr;23(4):625-34. doi: 10.1007/s10552-012-9931-z. Epub 2012 Mar 2.
To examine the relation between socio-demographic and clinical factors, and time from consultation to diagnosis and treatment for men with prostate cancer.
Men diagnosed with prostate cancer (n = 1,064, response rate = 82%) were recruited through participating urologists and hospital outpatient clinics in Queensland, Australia, and completed telephone interviews and self-administered questionnaires. Outcome measures were the diagnostic interval (initial consultation to definitive diagnosis) and treatment interval (definitive diagnosis to start of treatment).
Median time to diagnosis was 73 days (IQR = 41-144) and median treatment interval was 65 days (IQR = 36-107). After adjustment, men were more likely to wait more than 70 days for their definitive diagnosis when they initially presented with symptoms (compared with a general checkup) or did not have private health insurance. For treatment interval, men without private health insurance or who were treated with radiotherapy alone were more likely to wait more than 70 days. Treatment intervals were shorter when men received androgen deprivation therapy combined with radiotherapy.
Differences in waiting times for diagnosis and treatment related to access to private hospital care suggest that there are inequities in health-care service provision that are system based.
探讨社会人口学和临床因素与前列腺癌男性从就诊到诊断和治疗时间之间的关系。
通过参与澳大利亚昆士兰州的泌尿科医生和医院门诊招募了被诊断患有前列腺癌的男性(n=1064,应答率=82%),并通过电话访谈和自我管理问卷完成了调查。结局指标为诊断间隔(首次就诊到明确诊断)和治疗间隔(明确诊断到开始治疗)。
中位诊断时间为 73 天(IQR=41-144),中位治疗间隔为 65 天(IQR=36-107)。调整后,当男性最初出现症状(与一般检查相比)或没有私人医疗保险时,他们更有可能等待超过 70 天才能得到明确诊断。对于治疗间隔,没有私人医疗保险或仅接受放疗的男性更有可能等待超过 70 天。接受雄激素剥夺疗法联合放疗的男性治疗间隔较短。
与获得私人医院护理相关的诊断和治疗等待时间的差异表明,医疗服务提供存在基于系统的不公平现象。