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在印度尼西亚第二大医院进行宫颈癌诊断与治疗的艰难历程。

The challenging journey of cervical cancer diagnosis and treatment at the second largest hospital in Indonesia.

作者信息

Tjokroprawiro Brahmana Askandar, Novitasari Khoirunnisa, Saraswati Wita, Yuliati Indra, Ulhaq Renata Alya, Sulistya Hanif Ardiansyah

机构信息

Departement of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Jl. Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia.

出版信息

Gynecol Oncol Rep. 2024 Jan 18;51:101325. doi: 10.1016/j.gore.2024.101325. eCollection 2024 Feb.

Abstract

OBJECTIVES

Cervical cancer is a major health concern in developing countries. Access to preventive measures is limited in low- and middle-income countries, and cervical cancer is often identified at an advanced stage of the disease. In this study, we aimed to investigate when patients were first diagnosed and received treatment at a large hospital in Indonesia.

METHODS

Data were collected using a questionnaire from outpatient visits and descriptively analyzed. Totally, 215 cervical cancer patients being treated at the Dr. Soetomo Academic Hospital's gynecological oncology outpatient clinic in Indonesia between August and October 2022 were included.

RESULTS

Most patients were 51-60 years old (36.3 %), housewives (87 %), and had an elementary school education level (50 %). Most (88.4 %) admitted they were unaware about cervical cancer prevention, and 85.6 % never underwent screening. Most cervical biopsies were performed at primary hospitals (42.3 %). Fear of cancer treatment was the most frequent reason for patients arriving late at tertiary hospitals (50 %). Treatment delays occurred because patients had to visit two healthcare facilities before visiting a tertiary hospital (47.4 %). Most patients were diagnosed with stage III cancer (38.1 %), and chemotherapy was administered as the first-line therapy (96.3 %). Most patients (51.2 %) received their first therapy >12 months after initial symptom onset.

CONCLUSIONS

Most cervical cancer patients were diagnosed at a late stage owing to a lack of information regarding early symptoms and irregular screenings. Treatment was delayed owing to social barriers. Therefore, the government should have more strict policies to implement cervical cancer detection and prevention.

摘要

目的

宫颈癌是发展中国家主要的健康问题。在低收入和中等收入国家,获得预防措施的机会有限,宫颈癌往往在疾病晚期才被发现。在本研究中,我们旨在调查印度尼西亚一家大型医院的患者首次被诊断和接受治疗的时间。

方法

通过问卷调查收集门诊就诊数据并进行描述性分析。总共纳入了2022年8月至10月期间在印度尼西亚苏托莫博士学术医院妇科肿瘤门诊接受治疗的215例宫颈癌患者。

结果

大多数患者年龄在51 - 60岁之间(36.3%),为家庭主妇(87%),小学文化程度(50%)。大多数(88.4%)承认他们对宫颈癌预防一无所知,85.6%从未接受过筛查。大多数宫颈活检在基层医院进行(42.3%)。对癌症治疗的恐惧是患者延迟到三级医院就诊的最常见原因(50%)。治疗延迟是因为患者在前往三级医院之前必须先去两个医疗机构就诊(47.4%)。大多数患者被诊断为III期癌症(38.1%),一线治疗采用化疗(96.3%)。大多数患者(51.2%)在出现初始症状后>12个月才接受首次治疗。

结论

由于缺乏早期症状信息和筛查不规律,大多数宫颈癌患者被诊断时已处于晚期。治疗因社会障碍而延迟。因此,政府应制定更严格的政策来实施宫颈癌的检测和预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4240/10837473/746c33f09a8c/gr1.jpg

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