Lawaetz Mads, Jensen Ramon, Friborg Jeppe, Herlow Louise, Brofeldt Susanne, Fleischer Jens G, Homøe Preben
a Department of Otorhinolaryngology and Maxillofacial Surgery , Zealand University Hospital , Køge , Denmark.
b Department of Otolaryngology, Head & Neck Surgery and Audiology , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark.
Int J Circumpolar Health. 2018 Dec;77(1):1536252. doi: 10.1080/22423982.2018.1536252.
Previously, head and neck cancer (HNC) patients in Greenland have had significant diagnostic delay and poor survival rates. From 2005-2009 several initiatives have been made to ensure faster diagnosis and better survival. The aim of this study was to compare the prognosis before and after these initiatives were introduced. All Greenlandic patients diagnosed with HNC between 2005 and 2012 were included. Data were retrieved from medical records and national databases and compared with the period 1994-2003. A total of 98 patients were identified. Diagnostic delay was significantly lower compared to the period 1994-2004 (p=0.048). The 3-year overall survival was 56% for all HNC and 47% for nasopharyngeal carcinomas. We found that patients with HNC between 1994 and 2003 had a higher risk of death from all reasons compared with the period 2005-2012 (HR 2.17; CI 1.46-3.23) after adjustments for stage and diagnostic delay. Patients with head HNC in Greenland from 2005-2012 were diagnosed earlier and had a better overall survival compared to the period 1994-2003. The change in survival is more likely to be due to improvement in treatment rather than the initiated interventions. Although survival has improved in Greenland, demographic problems and lack of specialists remain a challenge.
此前，格陵兰岛的头颈癌（HNC）患者诊断延迟显著，生存率较低。2005年至2009年期间采取了多项举措，以确保更快的诊断和更好的生存率。本研究的目的是比较这些举措实施前后的预后情况。纳入了2005年至2012年间所有被诊断为HNC的格陵兰岛患者。数据从医疗记录和国家数据库中获取，并与1994年至2003年期间进行比较。共识别出98名患者。与1994年至2004年期间相比，诊断延迟显著降低（p = 0.048）。所有HNC患者的3年总生存率为56%，鼻咽癌患者为47%。我们发现，在对分期和诊断延迟进行调整后，1994年至2003年期间的HNC患者因各种原因死亡的风险高于2005年至2012年期间（风险比2.17；可信区间1.46 - 3.23）。与1994年至2003年期间相比，2005年至2012年期间格陵兰岛的头颈部HNC患者诊断更早，总生存率更高。生存率的变化更可能是由于治疗的改善，而非所采取的干预措施。尽管格陵兰岛的生存率有所提高，但人口问题和专科医生短缺仍然是一个挑战。
