Medical Affairs Department, Roche Central America and the Caribbean, Heredia, Costa Rica.
Department of Pharmacology, School of Medicine, University of Costa Rica, P.O. Box 2082, San Pedro, San José, Costa Rica.
Support Care Cancer. 2021 Feb;29(2):751-757. doi: 10.1007/s00520-020-05532-8. Epub 2020 May 26.
To identify the perspectives from healthcare providers about the limitations in referral, diagnosis, and treatment of lung cancer (LC) patients.
A cross-sectional study through an Internet-based survey was addressed to physicians of multidisciplinary teams in charge of LC patients from Cuba, Curacao, Costa Rica, Dominican Republic, El Salvador, Guatemala, Honduras, Jamaica, Panama, and Trinidad and Tobago. The questions focused on physicians' perspectives concerning waiting times and the availability of diagnostic and staging procedures in their settings, as well as the access to systemic therapies and continuous medical education (CME).
A total of 152 physicians responded to the online questionnaire (response rate 24.9%). Delays in biopsy results were the main barrier for LC diagnosis as identified by 48.2% of the respondents, followed by patients not being referred in time (31.3%), delays for staging procedures (11.4%), and time taken for biopsy (9%). Almost one-half of physicians perceived that patients are diagnosed in advanced stages. A total of 29 respondent physicians (19.1%) reported limited access to immunohistochemical or genetic analysis for common mutations. Although 73 physicians (48.0%) confirmed that their centers provided radiotherapy and systemic therapy for their patients, immunotherapy was not available in the institutions of 30 physicians (19.7%). A total of 42 practitioners (27.6%) reported that they did not have access to CME on LC topics due to working or budget restrictions.
This study revealed among respondents the main barriers for an appropriate management of LC patients in the Central American and Caribbean Region. Further studies must validate these findings.
确定医疗保健提供者对肺癌 (LC) 患者转诊、诊断和治疗局限性的看法。
通过基于互联网的调查进行了一项横断面研究，对象为负责来自古巴、库拉索、哥斯达黎加、多米尼加共和国、萨尔瓦多、危地马拉、洪都拉斯、牙买加、巴拿马和特立尼达和多巴哥的 LC 患者的多学科团队的医生。这些问题主要集中在医生对其所在环境中的诊断和分期程序的等待时间和可用性、以及获得系统治疗和持续医学教育 (CME) 的看法。
共有 152 名医生对在线问卷做出了回应（回应率 24.9%）。48.2%的受访者认为活检结果延迟是 LC 诊断的主要障碍，其次是患者未及时转诊（31.3%）、分期程序延迟（11.4%）和活检时间（9%）。近一半的医生认为患者被诊断为晚期。共有 29 名（19.1%）答复医生报告称，他们的中心无法进行常见突变的免疫组织化学或基因分析。尽管 73 名医生（48.0%）证实他们的中心为患者提供了放疗和系统治疗，但 30 名医生（19.7%）的机构没有提供免疫疗法。共有 42 名医生（27.6%）报告由于工作或预算限制，他们无法获得关于 LC 主题的 CME。
这项研究揭示了受访者中 LC 患者适当管理的主要障碍。还需要进一步的研究来验证这些发现。
