与胃癌就诊、诊断和治疗延迟相关的文化、社会和医疗保健获取因素：一项横断面研究。

Cultural, social, and healthcare access factors associated with delays in gastric cancer presentation, diagnosis, and treatment: A cross-sectional study.

机构信息

Universidade do Estado do Pará, Belém, Pará, Brazil.

Programa de Pós-Graduação em Saúde e Tecnologia, Universidade Federal do Maranhão, Imperatriz, Maranhão, Brazil.

出版信息

J Cancer Policy. 2021 Jun;28:100277. doi: 10.1016/j.jcpo.2021.100277. Epub 2021 Feb 9.

DOI:10.1016/j.jcpo.2021.100277

PMID:35559906

Abstract

BACKGROUND

The aim of this study was to identify the time intervals between the demand for health services and the initiation of cancer treatment, and to explore the associated factors, in gastric cancer patients being treated in an oncology hospital in northern Brazil.

METHODS

This cross-sectional study. Gastric cancer patients receiving treatment in a northern Brazil reference hospital were interviewed. A Mann-Whitney test was used to verify associations between the time intervals of access to treatment and socioeconomic factors, clinical variables, and patient difficulties, adopting a 0.05 significance level.

RESULTS

The average time intervals were 471.3 days between symptom onset and primary health service request and 180.9 days between diagnosis and treatment. The average time between the onset of symptoms and the treatment of gastric cancer was 747.8 days. Patients using herbal home remedies showed the longest times before seeking primary health care (p = 0.04). Delays between diagnosis and treatment were associated with unemployment (p = 0.03). High average times until oncologist appointments were related to the absence of comorbidities (p = 0.004). Personal difficulties and a lack of hospital beds were associated with long time intervals to specialist appointments and between diagnosis and treatment. Personal difficulties were associated with long time intervals between the onset of symptoms and the treatment of gastric cancer.

CONCLUSION

Gastric cancer patients faced delays and healthcare access barriers in a region with high mortality for this disease. Appropriate interventions are necessary to reduce delays and better control the disease.

POLICY SUMMARY

In this paper we have explored the barriers to access to diagnosis and treatment for patients with gastric cancer in a major cancer centre in Northern Brazil. The results will inform strategies for improving timely access to critical cancer services.

摘要

背景

本研究旨在确定巴西北部一家肿瘤医院治疗的胃癌患者从需求健康服务到开始癌症治疗的时间间隔，并探讨相关因素。

方法

这是一项横断面研究。对在巴西北部一家参考医院接受治疗的胃癌患者进行了访谈。采用曼-惠特尼检验来检验治疗时间间隔与社会经济因素、临床变量和患者困难之间的关联，采用 0.05 的显著性水平。

结果

症状出现与初级保健服务需求之间的平均时间间隔为 471.3 天，诊断与治疗之间的平均时间间隔为 180.9 天。症状出现到胃癌治疗的平均时间为 747.8 天。使用草药家庭疗法的患者在寻求初级保健之前的时间最长（p=0.04）。诊断与治疗之间的延迟与失业有关（p=0.03）。与无合并症的患者相比，平均等待时间较长的患者与肿瘤科医生预约有关（p=0.004）。个人困难和医院床位不足与专家预约和诊断与治疗之间的时间间隔较长有关。个人困难与从症状出现到胃癌治疗的时间间隔较长有关。