Servicio de Otorrinolaringología, Hospital Universitario Doctor Peset, Valencia, Spain.
Servicio de Otorrinolaringología, Hospital Universitario Doctor Peset, Valencia, Spain.
Acta Otorrinolaringol Esp (Engl Ed). 2022 Jan-Feb;73(1):19-26. doi: 10.1016/j.otoeng.2020.10.003.
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的重要预后因素。尽管几乎全民享有医疗保健，且头颈部肿瘤多有症状，但许多肿瘤仍被诊断为晚期。本文旨在确定我们卫生部门头颈部肿瘤的诊断延迟，并分析与延迟相关的因素，以及其是否与晚期诊断相关。
回顾性分析了 2016 年至 2018 年期间诊断为头颈部癌症的 137 例患者。评估了患者延迟、初级保健延迟、二级保健延迟、诊断延迟和可能的相关因素（吸烟、位置、分期等）。
许多患者（44.5%）被诊断为晚期。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。如果转诊是由其他专科医生进行的（p =.008），患者正在接受先前的治疗（P=.000）且肿瘤处于初始阶段（P=.038），则该延迟时间会更长。从首次就诊至耳鼻喉科的中位数为 15 天，常规转诊的中位数（43%）更高（P=.000）。诊断延迟的中位数为 12 天，手术活检的中位数更高（P=.000）。专业延迟的中位数为 58.5 天，总延迟为 118.5 天。
许多头颈部肿瘤被诊断为晚期。诊断为晚期与诊断延迟之间未发现相关性。但是，必须采取措施减少这些过长的延迟。
