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结直肠癌:巴西巴拉那州库里蒂巴市一家大学医院治疗的公共卫生系统使用者中与诊断延迟相关的因素。

COLORECTAL CANCER: factors related to late diagnosis in users of the public health system treated at an Universitary Hospital in Curitiba, Paraná State, Brazil.

作者信息

Souza Rosa Helena Silva, Maluf Eliane Mara Cesário Pereira, Sartor Maria Cristina, Carvalho Denise Siqueira de

机构信息

Programa de Pós Graduação em Medicina Interna, Universidade Federal do Paraná, Curitiba, PR, Brasil; , Universidade Federal do Paraná, Programa de Pós Graduação em Medicina Interna, Universidade Federal do Paraná, Curitiba PR , Brazil.

Serviço de Epidemiologia Hospitalar, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil; , Universidade Federal do Paraná, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba PR , Brazil.

出版信息

Arq Gastroenterol. 2016 Apr-Jun;53(2):68-75. doi: 10.1590/S0004-28032016000200004.

Abstract

BACKGROUND

  • The fourth most frequent tumor in the world, colorectal cancer is commonly diagnosed at an advanced stage.

OBJECTIVE

  • To analyze factors that interfere in the diagnosis of colorectal cancer in users of the Public Health System treated at an universitary hospital in Curitiba, Paraná State, Brazil.

METHODS

  • Cross-sectional, quantitative and descriptive study with 120 patients treated at the institution between 2012 and 2013. Data collection, carried out by means of medical record appointments and patients' interviews, addressed sociodemographic variables; clinical profile; timespan between symptoms, examination, diagnosis, treatment onset and difficulties encountered. Statistical analyses were performed by means of Stata 8.0.

RESULTS

  • Abdominal pain was the most frequent complaint and rectal bleeding presented the highest chance of advanced colorectal cancer diagnosis. From 52.5% of patients with late diagnosis of colorectal cancer, 81% reported difficulties in the health system.

CONCLUSION

  • Results suggest that late diagnosis is due to symptom absence in the early stage of the disease, patients' lack of perception about the severity of the symptoms, need of better of health teams to search early diagnosis. Educational interventions are deemed necessary to the population and health teams, besides actions prioritizing the access to diagnostic testing for serious illnesses.
摘要

背景

结直肠癌是全球第四大常见肿瘤,通常在晚期才被诊断出来。

目的

分析在巴西巴拉那州库里蒂巴市一家大学医院接受治疗的公共卫生系统使用者中,影响结直肠癌诊断的因素。

方法

对2012年至2013年间在该机构接受治疗的120名患者进行横断面、定量和描述性研究。通过病历预约和患者访谈收集数据,涉及社会人口统计学变量、临床特征、症状出现至检查、诊断、治疗开始的时间跨度以及遇到的困难。使用Stata 8.0进行统计分析。

结果

腹痛是最常见的主诉,直肠出血是晚期结直肠癌诊断的最高几率表现。在结直肠癌诊断延迟的患者中,52.5%的患者中有81%报告在卫生系统中遇到困难。

结论

结果表明,诊断延迟是由于疾病早期无症状、患者对症状严重程度缺乏认识、卫生团队需要更好地进行早期诊断。除了优先采取行动以获得重病诊断检测外,还认为有必要对公众和卫生团队进行教育干预。

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