Matarredona-Quiles Silvia, Martínez Ruíz de Apodaca Paula, Serrano Badía Ester, Ortega Beltrá Noelia, Dalmau-Galofre José
Servicio de Otorrinolaringología, Hospital Universitario Doctor Peset, Valencia, España.
Servicio de Otorrinolaringología, Hospital Universitario Doctor Peset, Valencia, España.
Acta Otorrinolaringol Esp (Engl Ed). 2021 Mar 10. doi: 10.1016/j.otorri.2020.10.001.
Tumour stage is an important prognostic factor in head and neck tumours. Many tumours are diagnosed in advanced stages despite almost universal healthcare and their being symptomatic. This paper seeks to determine the diagnostic delay in head and neck tumours in our health department, to analyse factors associated with delay and if it is associated with diagnosis in advanced stages.
Retrospective study of 137 patients with head and neck cancer diagnosed from 2016-2018. Patient delay, delay in primary health care, delay in secondary health care, diagnostic delay and possible associated factors (smoking, location, stage, …) were evaluated.
Many patients (44.5%) were diagnosed in advanced stages. The median patient delay was 30 days. The median referral to otorhinolaryngology was 3.5 days. If the referral was made by another specialist (p=.008), the patients were under previous treatment (P=.000) and the tumours were in initial stages (P=.038) this delay was greater. The median from the first visit to otorhinolaryngology was 15 days, higher in regular referrals (43%) (P=.000). The median diagnostic delay was 12 days, higher in surgical biopsies (P=.000). The median professional delay was 58.5 days and total delay was 118.5 days.
Many head and neck tumours are diagnosed in advanced stages. A relationship was not found between diagnosis in advanced stages and diagnostic delay. However, steps must be taken to reduce these excessive delays.
肿瘤分期是头颈部肿瘤重要的预后因素。尽管医疗保健几乎普及且肿瘤有症状，但许多肿瘤在晚期才被诊断出来。本文旨在确定我们卫生部门头颈部肿瘤的诊断延迟情况，分析与延迟相关的因素以及它是否与晚期诊断相关。
对2016年至2018年诊断的137例头颈部癌症患者进行回顾性研究。评估患者延迟、初级卫生保健延迟、二级卫生保健延迟、诊断延迟以及可能的相关因素（吸烟、部位、分期等）。
许多患者（44.5%）在晚期被诊断出来。患者延迟的中位数为30天。转诊至耳鼻喉科的中位数为3.5天。如果由另一位专科医生转诊（p = 0.008）、患者接受过先前治疗（P = 0.000）且肿瘤处于初始阶段（P = 0.038），则这种延迟会更长。从首次就诊到耳鼻喉科的中位数为15天，常规转诊的情况更高（43%）（P = 0.000）。诊断延迟的中位数为12天，手术活检的情况更高（P = 0.000）。专业延迟的中位数为58.5天，总延迟为118.5天。
许多头颈部肿瘤在晚期才被诊断出来。未发现晚期诊断与诊断延迟之间存在关联。然而，必须采取措施减少这些过度的延迟。
