Aboelkhir Hesham A B, El Alaoui Yousra, Padmanabhan Regina, Hadid Majed, Elomri Adel, Alam Tanvir, Rejeb Mohamed Amine, El Omri Halima, Taha Ruba Y, Elsabah Hesham, El Omri Abdelfatteh
Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar.
College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar.
Cancer Control. 2025 Jan-Dec;32:10732748241275026. doi: 10.1177/10732748241275026. Epub 2025 Mar 28.
ObjectivesWhile delays in leukemia detection remain an ongoing challenge in hematologic cancer care, little is known about the factors associated with these delays. This article focuses on identifying the barriers hindering timely diagnosis of leukemia through a cohort analysis (2016-2021) of 220 Acute Myeloid Leukemia (AML), 161 Chronic Myeloid Leukemia (CML), 90 Acute Lymphocytic Leukemia (ALL), and 121 Chronic Lymphocytic Leukemia (CLL) patients in Qatar.MethodsOf the 592 patients used for the study, subsets were identified and analyzed for delay (423), risk stratification (437), and leukemia stage (282).ResultsThere was an increasing trend in leukemia cases, with 32% of patients being diagnosed in the high-risk category. Out of 423 (median delay = 28 days) patients, 45% reported delayed diagnosis (median delay = 44 days). Further analysis of the association of delayed leukemia diagnosis using the univariate 2 independence test revealed significant associations to patient referral type, and the presence of certain comorbidities and symptoms.ConclusionSignificant delays in leukemia diagnosis were identified, though the exact cause remains unclear. These delays can be attributed to factors such as patient, primary care, referral, system, and physician delays. Therefore, further investigation is imperative for improving the detection, diagnosis, and referral processes in hematologic cancers.
目的
虽然白血病检测延迟仍是血液系统癌症治疗中持续存在的挑战,但对于与这些延迟相关的因素知之甚少。本文通过对卡塔尔220例急性髓系白血病(AML)、161例慢性髓系白血病(CML)、90例急性淋巴细胞白血病(ALL)和121例慢性淋巴细胞白血病(CLL)患者进行队列分析(2016 - 2021年),重点确定阻碍白血病及时诊断的障碍。
方法
在用于该研究的592例患者中,确定子集并分析延迟情况(423例)、风险分层(437例)和白血病分期(282例)。
结果
白血病病例呈上升趋势,32%的患者被诊断为高危类别。在423例患者中(中位延迟 = 28天),45%报告诊断延迟(中位延迟 = 44天)。使用单变量2独立性检验对白血病延迟诊断的关联进行进一步分析,发现与患者转诊类型、某些合并症和症状的存在有显著关联。
结论
已确定白血病诊断存在显著延迟,尽管确切原因尚不清楚。这些延迟可归因于患者、初级保健、转诊、系统和医生等方面的延迟因素。因此,必须进一步调查以改善血液系统癌症的检测、诊断和转诊流程。