Allison P, Franco E, Feine J
Faculty of Dentistry, McGill University, Montreal, Canada.
Oral Oncol. 1998 Mar;34(2):127-32. doi: 10.1016/s1368-8375(97)00078-x.
In spite of the belief that cancer mortality can be reduced if lesions are detected, diagnosed and treated at an early stage, the predictors of diagnostic delays for upper aerodigestive tract (UADT) cancers have been the subject of little research. The aim of this study was to investigate the role of selected variables as predictors of professional diagnostic delays in a sample of UADT cancer patients. Patients diagnosed with squamous cell carcinoma of oral cavity sites (ICD-9 141, 143-5) oro-, naso- and hypopharynx (ICD-9 146-8) and larynx (ICD-9 161) were included in the study. Multiple logistic regression was used to calculate the odds ratio (OR) for professional delay > 1 month versus professional delay < 1 month for selected study variables. The sample comprised 188 subjects. Multivariate analysis found that the presence of comorbidity at the time of presentation of UADT symptoms (OR 2.84; 95% CI 1.35-5.98), age > or = 65 years (OR 0.31; 95% CI 0.15-0.64), higher education (OR 0.45; 95% CI 0.22-0.93) and cancer at an oral cavity site (OR 0.31; 95% CI 0.15-0.64) were the explanatory variables for professional delay. This study suggests that, among UADT cancer patients, the presence of comorbidity at the time of presentation increases the odds for a professional delay > 1 month, while older age, higher education and oral cancer reduce the odds.
尽管人们认为，如果能在早期发现、诊断和治疗病变，癌症死亡率是可以降低的，但上呼吸道消化道（UADT）癌症诊断延迟的预测因素却很少受到研究。本研究的目的是调查选定变量作为UADT癌症患者样本中专业诊断延迟预测因素的作用。本研究纳入了被诊断为口腔部位（国际疾病分类第九版141、143 - 5）、口咽、鼻咽和下咽（国际疾病分类第九版146 - 8）以及喉（国际疾病分类第九版161）鳞状细胞癌的患者。采用多元逻辑回归计算选定研究变量专业延迟>1个月与专业延迟<1个月的比值比（OR）。样本包括188名受试者。多变量分析发现，出现UADT症状时存在合并症（OR 2.84；95%置信区间1.35 - 5.98）、年龄≥65岁（OR 0.31；95%置信区间0.15 - 0.64）、高等教育程度（OR 0.45；95%置信区间0.22 - 0.93）以及口腔部位癌症（OR 0.31；95%置信区间0.15 - 0.64）是专业延迟的解释变量。本研究表明，在UADT癌症患者中，出现症状时存在合并症会增加专业延迟>1个月的几率，而年龄较大、高等教育程度和口腔癌则会降低这种几率。
