Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Clinical Sciences, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Ann Med. 2021 Dec;53(1):26-33. doi: 10.1080/07853890.2020.1802060. Epub 2020 Aug 5.
Early diagnosis of head and neck cancer (HNC) will improve patient outcomes. The low incidence of HNC renders its detection challenging for a general practitioner (GP) in primary health care (PHC).
To examine these challenges, our cohort consisted of all patients visiting PHC centres in the City of Helsinki in 2016. We chose 57 ICD-10 codes representing a sign or symptom resulting from a possible HNC and compared data for all new HNC patients.
A total of 242,211 patients (499,542 appointments) visited PHC centres, 11,896 (5%) of whom presented with a sign or symptom possibly caused by HNC. Altogether, 111 new HNCs were diagnosed within the Helsinki area, of which 40 (36%) were referred from PHC. The median delay from the initial PHC visit to the referral to specialist care was 5 days, whereby 88% of patients were referred within one month.
Despite the low incidence of HNC and the large number of patients presenting with HNC-related symptoms, GPs working in PHC sort out potential HNC patients from the general patient group in most cases remarkably effectively. KEY MESSAGES For every head and neck cancer (HNC) patient encountered in the primary health care, a general practitioner (GP) will meet approximately 6000 other patients, 100 of whom exhibit a sign or a symptom potentially caused by a HNC. Despite the low incidence of HNC, GPs referred patients to specialist care effectively, limiting the median delay from the initial appointment to referral to only 5 days.
早期诊断头颈部癌症（HNC）将改善患者的预后。HNC 的发病率较低，这使得初级卫生保健（PHC）中的全科医生（GP）难以发现。
为了研究这些挑战，我们的队列包括 2016 年访问赫尔辛基市 PHC 中心的所有患者。我们选择了 57 个 ICD-10 代码，代表可能由 HNC 引起的症状或体征，并比较了所有新的 HNC 患者的数据。
共有 242211 名患者（499542 次就诊）访问了 PHC 中心，其中 5%的患者出现了可能由 HNC 引起的症状或体征。在赫尔辛基地区共诊断出 111 例新的 HNC，其中 40 例（36%）是从 PHC 转诊的。从最初的 PHC 就诊到转至专科治疗的中位时间为 5 天，其中 88%的患者在一个月内转诊。
尽管 HNC 的发病率较低，且出现 HNC 相关症状的患者数量较多，但在 PHC 工作的 GPs 通常能够非常有效地从一般患者群体中筛选出可能的 HNC 患者。关键信息：在初级卫生保健中遇到的每一位头颈部癌症（HNC）患者，GP 大约会遇到 6000 名其他患者，其中 100 名患者表现出可能由 HNC 引起的症状或体征。尽管 HNC 的发病率较低，但 GP 有效地将患者转介至专科治疗，将首次就诊到转介的中位时间限制在仅 5 天。
