Tarburn Emma-Louise, Iversen Lisa, Robertson Charlotte, McShane Charlene, Duncombe Andrew, McMullin Mary-Frances, Harrison Claire, Mesa Ruben, Anderson Lesley A
Aberdeen Centre for Health Data Science, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
BJGP Open. 2025 Apr 24;9(1). doi: 10.3399/BJGPO.2024.0068. Print 2025 Apr.
Early cancer recognition is key to improving patient outcomes. Diagnosis is often delayed in patients with myeloproliferative neoplasms (MPNs), putting them at risk of thromboembolic events and other complications pre-diagnosis. A clear understanding of the barriers to presentation and diagnosis is required.
To explore barriers and factors influencing delayed presentation and diagnosis of MPNs.
DESIGN & SETTING: A cross-sectional study of patients with MPN within the UK and the Republic of Ireland.
An online cross-sectional survey of patients with MPN was undertaken. Symptoms and factors influencing patient and GP delay were examined. Adjusted odds ratios (aORs) were calculated to explore the relationship between these factors and patient and GP delay.
Most (80.2%) of the 620 patients completing the survey reported symptomatic presentation. The most common symptoms associated with patient delay were pruritus (aOR 1.89, 95% confidence interval [CI] = 1.19 to 3.01), headaches (aOR 1.86, 95% CI = 1.13 to 2.82), and concentration difficulties (aOR 1.75, 95% CI = 1.12 to 2.76). Attributing symptoms to ageing (aOR 1.92, 95% CI = 1.19 to 3.11) and not wanting to burden the GP (2.04, 95% CI = 1.24 to 3.39) were significantly associated with patient delay. Those reporting >3 blood cancer warning signs were more likely to experience GP delay than those experiencing fewer (aOR 3.26 95% CI = 1.75 to 6.29), and lack of relational continuity of GP care was significantly associated with GP delay (aOR 3.41, 95% CI = 1.65 to 7.28).
Debunking misconceptions around ageing, encouraging timely communication with GPs, and improving relational continuity of GP care could assist in reducing diagnostic delays, prevent potentially fatal disease complications, and ultimately improve outcomes for patients with MPN.
早期癌症识别是改善患者预后的关键。骨髓增殖性肿瘤（MPN）患者的诊断往往会延迟，使他们在诊断前面临血栓栓塞事件和其他并发症的风险。需要清楚了解就诊和诊断的障碍。
探讨MPN延迟就诊和诊断的障碍及影响因素。
对英国和爱尔兰共和国的MPN患者进行的横断面研究。
对MPN患者进行在线横断面调查。检查了影响患者和全科医生延迟的症状和因素。计算调整后的优势比（aOR）以探讨这些因素与患者和全科医生延迟之间的关系。
完成调查的620名患者中，大多数（80.2%）报告有症状表现。与患者延迟相关的最常见症状是瘙痒（aOR 1.89，95%置信区间[CI]=1.19至3.01）、头痛（aOR 1.86，95%CI=1.13至2.82）和注意力不集中（aOR 1.75，95%CI=1.12至2.76）。将症状归因于衰老（aOR 1.92，95%CI=1.19至3.11）和不想给全科医生添麻烦（2.04，95%CI=1.24至3.39）与患者延迟显著相关。报告有>3个血癌警示信号的患者比警示信号较少的患者更有可能经历全科医生延迟（aOR 3.26，95%CI=1.75至6.29），并且全科医生护理缺乏关系连续性与全科医生延迟显著相关（aOR 3.41，95%CI=1.65至7.28）。
消除对衰老的误解、鼓励与全科医生及时沟通以及改善全科医生护理的关系连续性有助于减少诊断延迟，预防潜在的致命疾病并发症，并最终改善MPN患者的预后。
