Atula Markus, Aro Katri, Irjala Heikki, Halme Elina, Jouppila-Mättö Anna, Koivunen Petri, Wilkman Tommy, Blomster Henry, Mäkitie Antti, Atula Timo
Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, University of Turku, Turku, Finland.
Head Neck. 2023 May;45(5):1215-1225. doi: 10.1002/hed.27335. Epub 2023 Mar 7.
Head and neck cancers (HNCs) are often diagnosed at an advanced stage. We investigated the lengths and factors associated with patient, primary health care (PHC), and specialist care (SC) delays in T3-T4 oral, oropharyngeal, and laryngeal cancer.
A nationwide prospective questionnaire-based study (n = 203) with the 3-year long data collection period.
The median patient, PHC and SC delays were 58, 13, and 43 days, respectively. Lower level of education, heavy alcohol use, hoarseness, difficulties breathing, and eventual palliative treatment associated with a longer patient delay. A lump on the neck or facial swelling associated with a shorter PHC delay. Conversely, if symptoms were treated as an infection, PHC delay was longer. The treatment modality and tumor site affected SC delay.
Patient delay stands as the most notable factor contributing to delays before treatment. HNC symptom awareness thus remains especially important among HNC risk groups.
头颈癌（HNCs）往往在晚期才被诊断出来。我们调查了T3 - T4期口腔癌、口咽癌和喉癌患者、初级卫生保健（PHC）及专科护理（SC）延误的时长及相关因素。
一项基于问卷的全国性前瞻性研究（n = 203），数据收集期长达3年。
患者、初级卫生保健及专科护理延误的中位数分别为58天、13天和43天。教育程度较低、大量饮酒、声音嘶哑、呼吸困难以及最终接受姑息治疗与患者延误时间较长相关。颈部肿块或面部肿胀与初级卫生保健延误时间较短相关。相反，如果症状被当作感染治疗，初级卫生保健延误时间则较长。治疗方式和肿瘤部位影响专科护理延误。
患者延误是导致治疗前延误的最显著因素。因此，对头颈癌风险人群而言，提高对头颈癌症状的认识仍然尤为重要。
