Lewis Liane, Marcu Afrodita, Whitaker Katriina, Maguire Roma
School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK.
Eur J Cancer Care (Engl). 2018 Jan;27(1). doi: 10.1111/ecc.12745. Epub 2017 Aug 31.
Oesophageal cancer (EC) is characterised by vague symptoms and is often diagnosed at an advanced stage, leading to poor outcomes. Therefore, we aimed to investigate whether there might be any patient factors contributing to delay in EC diagnosis, and focused on the symptom appraisal and help-seeking strategies of people diagnosed with EC in the UK. Semi-structured interviews were conducted with 14 patients aged >18 years with localised EC at point of diagnosis. Purposive sampling was used to include patients from 1 to 9 months post-diagnosis. Analysis of the interviews identified three main themes: Interpreting symptoms, Triggers to seeking help and Making sense of an unfamiliar cancer. Findings suggested that participants normalised symptoms or used previous health experiences as a means to interpret their symptoms. The majority of participants were not alarmed by their symptoms, mainly because they had very little knowledge of EC specific symptoms. Lack of knowledge also influenced participants' sense-making of their diagnosis. The findings highlight that the process of symptom appraisal in EC is likely to be inaccurate, which may hinder early presentation and thus diagnosis. Public health campaigns communicating EC specific symptoms, however, could shorten the appraisal period and lead to earlier diagnosis.
食管癌（EC）的症状不明确，常常在晚期才被诊断出来，导致治疗效果不佳。因此，我们旨在调查是否存在导致食管癌诊断延迟的患者因素，并重点关注英国食管癌患者的症状评估和求助策略。我们对14名年龄大于18岁、诊断时患有局限性食管癌的患者进行了半结构化访谈。采用目的抽样法纳入诊断后1至9个月的患者。对访谈的分析确定了三个主要主题：症状解读、寻求帮助的触发因素以及理解一种不熟悉的癌症。研究结果表明，参与者将症状正常化，或利用以往的健康经历来解读自己的症状。大多数参与者对自己的症状并不警觉，主要是因为他们对食管癌的特定症状了解甚少。知识的缺乏也影响了参与者对自己诊断结果的理解。研究结果表明，食管癌的症状评估过程可能不准确，这可能会阻碍早期就诊，进而影响诊断。然而，宣传食管癌特定症状的公共卫生运动可以缩短评估期，从而实现更早的诊断。
