Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
ASEAN Cancer Epidemiology and Prevention Research Group (ACEP), Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
Asian Pac J Cancer Prev. 2020 Jun 1;21(6):1835-1840. doi: 10.31557/APJCP.2020.21.6.1835.
Colorectal cancer (CRC) is among the five-leading cancers in Thailand. Delayed diagnosis is crucial for undermining the prognosis of the patients. This study aims to evaluate the factors associated with the time interval for diagnosis (TID).
A cross-sectional analytical study of 191 CRC patients with histological confirmation who were undergoing treatment in the tertiary hospital in Khon Kaen Province was conducted. The data were obtained by interview and retrieving from medical records. The time interval in each diagnostic process is reported in geometric mean. The geometric mean ratio (GMR) used to interpret the results from multiple linear regressions that analyze the relationship between factors and log-transformed TID.
Most patients were males (61.78%) with mean age of 61.28±10.2 years old. The geometric mean of TID was 263.48 days. Two factors were significantly associated with longer TID: first visit at a tertiary hospital (GMR=7.77 relative to secondary hospital; 95%CI=1.95 to 30.57) and distance to tertiary healthcare. Two factors were significantly associated with shorter TID: officer/ state enterprise (GMR=0.53 relative to agriculture; 95%CI=0.28 to 0.98) and cost of traveling to secondary healthcare.
The results showed the occupation, first health care visit, distance and cost were factors associated with TID. Improving the facilities at the secondary healthcare units for diagnosing CRC would be likely to help to reduce the wasted time in the healthcare system.
结直肠癌（CRC）是泰国五种主要癌症之一。延迟诊断对破坏患者的预后至关重要。本研究旨在评估与诊断时间间隔（TID）相关的因素。
对在孔敬府一家三级医院接受治疗的 191 名经组织学证实的 CRC 患者进行了横断面分析研究。通过访谈和从病历中获取数据。每个诊断过程中的时间间隔以几何平均值报告。几何均数比（GMR）用于解释多线性回归分析的结果，该回归分析用于分析因素与对数转换 TID 之间的关系。
大多数患者为男性（61.78%），平均年龄为 61.28±10.2 岁。TID 的几何平均值为 263.48 天。有两个因素与较长的 TID 显著相关：三级医院的首次就诊（GMR=7.77，与二级医院相比；95%CI=1.95 至 30.57）和距离三级医疗保健。有两个因素与较短的 TID 显著相关：官员/国有企业（GMR=0.53，与农业相比；95%CI=0.28 至 0.98）和前往二级医疗保健的旅行费用。
结果表明，职业、首次医疗保健就诊、距离和费用是与 TID 相关的因素。改善二级医疗机构诊断 CRC 的设施，可能有助于减少医疗系统中的浪费时间。
