Araz Nilgun Col, Guler Elif
Department of Social Pediatrics, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey.
Pediatr Hematol Oncol. 2015 Mar;32(2):153-63. doi: 10.3109/08880018.2013.874511. Epub 2014 Feb 5.
In childhood cancer patients, early diagnosis may have an impact on survival that reduces the potential morbidity. This study aimed to identify the factors associated with delay in diagnosis in children with cancer in southeastern Turkey. The clinical records of 682 patients with childhood cancer were evaluated. Study variables were classified as factors related to the patient, their disease, and the health care system. The median parental delay, physician delay, and total delay were determined as 20, 23, and 60 days, respectively. There was a significant relationship between parental delay, physician delay, and total delay and age at diagnosis (P = .005, P = .008, and P = .004, respectively). Long parental delay was least frequent in children younger than 1 year (P = .001). Parental, physician, and total delay were longer in patients with solid tumors than in patients with leukemias (P = .007, P = .000, and P = .000, respectively). Patients with tumors of the genitalia had longer physician delay and total delay than patients with other solid tumors (P = .001 and P = .000, respectively). Patients with solid tumor and early-stage disease had longer physician delay and total delay (P = .016 and P = .013, respectively). According to the first physician contacted, long physician delay was less frequent among pediatricians (P = .003). Delayed diagnosis was associated with age, type/localization and stage of tumor, the first physician consulted, and area of residence. A sustained effort should be made to raise the level of awareness of childhood cancer among parents and to sensitize all physicians, especially those who treat pediatric patients infrequently, with regard to the warning signs of the disease.
在儿童癌症患者中,早期诊断可能会对生存产生影响,降低潜在的发病率。本研究旨在确定土耳其东南部儿童癌症患者诊断延迟的相关因素。对682例儿童癌症患者的临床记录进行了评估。研究变量分为与患者、其疾病以及医疗保健系统相关的因素。确定父母延迟、医生延迟和总延迟的中位数分别为20天、23天和60天。父母延迟、医生延迟和总延迟与诊断时的年龄之间存在显著关系(分别为P = .005、P = .008和P = .004)。1岁以下儿童父母延迟时间长的情况最少见(P = .001)。实体瘤患者的父母延迟、医生延迟和总延迟时间比白血病患者长(分别为P = .007、P = .000和P = .000)。生殖器肿瘤患者的医生延迟和总延迟时间比其他实体瘤患者长(分别为P = .001和P = .000)。实体瘤和早期疾病患者的医生延迟和总延迟时间更长(分别为P = .016和P = .013)。根据首次接触的医生来看,儿科医生中医生延迟时间长的情况较少见(P = .003)。诊断延迟与年龄、肿瘤类型/部位和分期、首次咨询的医生以及居住地区有关。应持续努力提高父母对儿童癌症的认识水平,并使所有医生,尤其是那些不经常治疗儿科患者的医生,对该疾病的警示信号保持敏感。