Caplan L S
Department of Preventive Medicine, State University of New York at Stony Brook 11794-8036, USA.
Public Health Rev. 1995;23(3):263-74.
Patient delay in seeking medical attention could be a contributing cause in a substantial number of breast cancer deaths. The purpose of this study was to identify factors associated with long delay in order to identify specific groups in need of more intensive education regarding the signs of breast cancer and the importance of early treatment.
A study of 162 women with potential breast cancer symptoms was done in the area of Worcester, MA. Two methods of analysis were used. A case-control approach was used where the outcome variable was categorized into two groups of longer and shorter delay, and a survival analysis was used where the outcome variable was treated as a continuous variable.
It was found that women with increasing symptoms were more likely to delay than women whose symptoms either decreased or remained the same. Women performing monthly breast self-examination and/or receiving at least bi-annual mammograms were much less likely to delay than women who performed breast self-examination or received mammograms less often. It was also found that women using family practitioners were less likely to delay than women using other types of physicians.
Patient delay continues to be a major problem in breast cancer, as 16% of the women here delayed at least two months before seeking help. This study presented a new and improved method for defining patient delay, which should be explored further in larger studies.
患者寻求医疗关注的延迟可能是导致大量乳腺癌死亡的一个促成因素。本研究的目的是确定与长期延迟相关的因素,以便确定需要就乳腺癌症状及早期治疗的重要性接受更强化教育的特定群体。
在马萨诸塞州伍斯特地区对162名有潜在乳腺癌症状的女性进行了一项研究。采用了两种分析方法。一种病例对照方法,将结果变量分为延迟较长和较短的两组;另一种生存分析方法,将结果变量视为连续变量。
发现症状加重的女性比症状减轻或不变的女性更有可能延迟。每月进行乳房自我检查和/或至少每两年接受一次乳房X光检查的女性比那些较少进行乳房自我检查或接受乳房X光检查的女性延迟的可能性要小得多。还发现,看家庭医生的女性比看其他类型医生的女性延迟的可能性要小。
患者延迟仍然是乳腺癌中的一个主要问题,因为这里16%的女性在寻求帮助前至少延迟了两个月。本研究提出了一种新的、改进的定义患者延迟的方法,应在更大规模的研究中进一步探索。