Alahapperuma Laurence Shreenikumari, Fernando Eshani Anoja
Dental Surgeon, Oral Cancer Department, National Cancer Control Programme, Ministry of Health, Sri Lanka. Email:
Asian Pac J Cancer Prev. 2017 Feb 1;18(2):321-325. doi: 10.22034/APJCP.2017.18.2.321.
Background: Diagnosis of cancer at an early stage improves prognosis following treatment. Unfortunately a large proportion of oral and pharyngeal cancer patients are diagnosed at late stages which require radical treatment with considerable morbidity and mortality. Many researchers have examined different types of delay that could occur between the onset of symptoms and diagnosis. The objective of this research was to identify patient-linked delays between the time of first noticing symptoms and definitive diagnosis, and its association with the stage at diagnosis among oral and pharyngeal carcinoma patients attending the National Cancer Institute, Maharagama, Sri Lanka. Methods: A hospital-based descriptive cross-sectional study was carried out on 351 patients with histologically confirmed carcinoma of oral cavity and pharynx. Data were collected using an interviewer- administered questionnaire and a data extraction sheet. If a patient had taken more than three months to visit a Health Care Practitioner, it was considered as ‘Patient Delay-1’. If a patient had taken more than two weeks following referral to reach for specialized cancer care, it was considered as ‘Patient Delay 2’. Results: Proportions of ‘Patient Delay-1’ and ‘Patient Delay-2’ were 19% (n=252) and 16% (n=322) respectively. Mean time duration between noticing symptoms to definitive diagnosis was 14.1 weeks (SD=10.3). The proportion of advanced-stage cancers at diagnosis was 59.8%. Conclusion: Stage at diagnosis was significantly associated with ‘Patient Delay -1’ (p = 0.001) but not with ‘Patient Delay-2’. ‘Patient Delay-1’ was significantly associated with level of education (p = 0.001) and the cost of travelling (p = 0.048).
癌症早期诊断可改善治疗后的预后。不幸的是，很大一部分口腔和咽癌患者在晚期才被诊断出来，这需要进行根治性治疗，且会带来相当高的发病率和死亡率。许多研究人员研究了症状出现与诊断之间可能发生的不同类型的延迟。本研究的目的是确定在斯里兰卡马哈拉加马国家癌症研究所就诊的口腔和咽癌患者从首次注意到症状到确诊之间与患者相关的延迟，以及其与诊断时分期的关联。方法：对351例经组织学确诊的口腔和咽癌患者进行了一项基于医院的描述性横断面研究。使用访谈式问卷和数据提取表收集数据。如果患者花了三个多月才去看医疗保健从业者，则被视为“患者延迟-1”。如果患者在转诊后花了两周多时间才获得专门的癌症护理，则被视为“患者延迟-2”。结果：“患者延迟-1”和“患者延迟-2”的比例分别为19%（n = 252）和16%（n = 322）。从注意到症状到确诊的平均时间为14.1周（标准差 = 10.3）。诊断时晚期癌症的比例为59.8%。结论：诊断时的分期与“患者延迟-1”显著相关（p = 0.001），但与“患者延迟-2”无关。“患者延迟-1”与教育水平（p = 0.001）和交通费用（p = 0.048）显著相关。
