Sánchez Galindo Blanca, López-Torres Hidalgo Jesús, López González Ángel, Sánchez Martínez Carmen María, Castaño Díaz Marta, Rabanales Sotos Joseba
Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España.
Medicina de Familia, Servicio de Salud de Castilla-La Mancha; Facultad de Medicina, Universidad de Castilla-La Mancha-UCLM, Albacete, España; Grupo de Actividades Preventivas en el ámbito universitario de Ciencias de la Salud (UCLM), Albacete, España.
Aten Primaria. 2025 Mar;57(3):103153. doi: 10.1016/j.aprim.2024.103153. Epub 2024 Dec 7.
To describe the delay in the diagnosis of breast cancer in primary care and to identify the patient, care process and disease variables involved in the delay to diagnosis and treatment.
Retrospective study with follow-up of a cohort of women with breast cancer, from the first symptoms to the start of treatment. SITE: In total 24 family medicine practices with information from both primary care and hospital settings.
446 women were evaluated (period 2014-2023).
Patient characteristics (age, history and comorbidity), care process (screening, consultation site and referral priority) and disease characteristics (stage, presentation and risk factors) were included. Time intervals considered included, among others, «primary care interval», «health system interval», «diagnosis interval» and «treatment interval».
The mean value of the «primary care interval» was 24.7days (median: 16); that of the «hospital care interval», 77.2days (median: 68); and that of the «health system interval», 93.6days (median: 83). Multiple linear regression showed a significantly shorter duration of the interval in women referred preferentially, in advanced stages, with a breast lump at presentation and with risk factors.
Most are diagnosed in early stages at the health centre. The duration of the «health system interval» is shorter in preferential referrals, when the form of presentation is a breast lump, with risk factors and in advanced stages.
描述基层医疗中乳腺癌诊断的延迟情况,并确定诊断和治疗延迟所涉及的患者、医疗过程及疾病变量。
对一组乳腺癌女性患者进行回顾性研究,从首次出现症状到开始治疗进行随访。地点:共有24家家庭医疗诊所,提供基层医疗和医院环境的信息。
对446名女性进行了评估(2014 - 2023年期间)。
纳入患者特征(年龄、病史和合并症)、医疗过程(筛查、就诊地点和转诊优先级)以及疾病特征(分期、表现和危险因素)。所考虑的时间间隔包括“基层医疗间隔”“卫生系统间隔”“诊断间隔”和“治疗间隔”等。
“基层医疗间隔”的平均值为24.7天(中位数:16天);“医院医疗间隔”为77.2天(中位数:68天);“卫生系统间隔”为93.6天(中位数:83天)。多元线性回归显示,优先转诊的女性、处于晚期、就诊时乳房有肿块且有危险因素的女性,其间隔时间明显较短。
大多数患者在健康中心被诊断为早期。在优先转诊、表现形式为乳房肿块、有危险因素且处于晚期的情况下,“卫生系统间隔”的时间较短。