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尼泊尔肺癌患者就医途径中各阶段的时长。

Duration of intervals in the care-seeking pathway of lung cancer in Nepal.

作者信息

Pandey Shama, Paudel Bishnu Dutta, Acharya Bibek, Acharya Sandhya Chapagain, Karn Ambuj, Poudyal Saugat, Poudel Manish, Thapa Pradeep, Gurung Jasmine, Shilpakar Ramila

机构信息

National Academy of Medical Sciences, Bir Hospital, Kathmandu 44600, Nepal.

KIST Medical College and Teaching Hospital, Lalitpur 44700, Nepal.

出版信息

Ecancermedicalscience. 2025 Jan 16;19:1825. doi: 10.3332/ecancer.2025.1825. eCollection 2025.

Abstract

INTRODUCTION

Patients with lung cancer in Nepal often present at an advanced stage. The purpose of this study was to determine the access, diagnostic and treatment intervals in patients with lung cancer and to identify factors that may be causing the delays leading to advanced presentation.

METHODS

This was a descriptive, cross-sectional study conducted in the Department of Clinical Oncology, Bir Hospital from July 2023 to April 2024 after obtaining ethical approval from the Institutional Review Board. Patients with newly diagnosed lung cancer were interviewed and data was collected. Data were presented in the forms of percentages and mean/median. Univariate and multivariate logistic regression analysis was done to assess the association between various factors and different delays.

RESULTS

Of the 100 patients included, 56% were men and the mean age was 64.5 ± 10.8 years. 64% of the patients had stage IV disease. The median access, diagnostic and treatment interval were 44.5 days, 45.5 days and 26 days, respectively. Access, diagnostic and treatment delays were seen in 72%, 63% and 42% of the patients, respectively. Receiving empirical anti-tubercular treatment and visiting informal healthcare providers as their first healthcare contact was associated with diagnostic delay whereas smoking was associated with treatment delay.

CONCLUSION

There is a significant delay in the care-seeking pathway of lung cancer in Nepal. Implementing corrective measures to address these could help improve the outcomes for these patients.

摘要

引言

尼泊尔的肺癌患者往往在疾病晚期才就诊。本研究的目的是确定肺癌患者的就诊、诊断和治疗间隔,并找出可能导致延迟就诊从而致使疾病晚期的因素。

方法

这是一项描述性横断面研究,于2023年7月至2024年4月在比尔医院临床肿瘤学系进行,研究获得了机构审查委员会的伦理批准。对新诊断为肺癌的患者进行了访谈并收集了数据。数据以百分比和均值/中位数的形式呈现。进行单因素和多因素逻辑回归分析以评估各种因素与不同延迟之间的关联。

结果

纳入的100例患者中,56%为男性,平均年龄为64.5±10.8岁。64%的患者患有IV期疾病。就诊、诊断和治疗的中位间隔分别为44.5天、45.5天和26天。分别有72%、63%和42%的患者出现就诊延迟、诊断延迟和治疗延迟。接受经验性抗结核治疗以及首次就医时拜访非正规医疗服务提供者与诊断延迟相关,而吸烟与治疗延迟相关。

结论

尼泊尔肺癌患者的就医途径存在显著延迟。采取纠正措施来解决这些问题有助于改善这些患者的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f7/11959116/53def4c54067/can-19-1825fig1.jpg

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