背景:口腔癌是世界上十大最常见的恶性肿瘤之一,大约90%的病例是OSCC。尽管现有的治疗方式取得了进展,OSCC患者的死亡率在过去20年中一直居高不下.生存数据受到诊断时机的强烈影响:超过50%的患者在晚期被诊断,5年生存率低于50%。因此,早期诊断对改善患者预后起着至关重要的作用,早期癌症的存活率超过90%,而降至5-20%的III期和IV期疾病。这项前瞻性研究旨在评估诊断延迟,并研究各种患者和肿瘤因素及其与它们的关联。
方法:这项前瞻性观察性研究于2023年12月至2024年2月进行。本研究的病例包括经临床诊断的口腔鳞状细胞癌,放射学和/或组织学确认。根据患者自己的通知,记录患者的延误天数,关于他们症状的发作到就医的时间。然后,这与各种患者和肿瘤相关因素有关。
结果:总共对120名(n)患者进行了访谈,并招募了这些患者的病例表用于本研究。发现整个人群的中位主要延迟为90天,而中位次要延迟为11天。发现总延迟的中位数为106天。女性和年轻人群的中位总延迟较高,尽管没有统计学意义。然而,教育显示出显着影响,识字的患者出现得更早。吸烟和酗酒对延迟没有显着影响。各种肿瘤因素对延迟也没有任何统计学意义的影响,尽管,晚期和淋巴结次级的患者在更晚的时间出现。
结论:与患者和肿瘤相关的因素以及与卫生保健提供者首次接触时做出的决定都会影响专家咨询前的延迟。在普通人群和全科医生中提高对HNC症状的认识是使患者获得治愈性治疗而不会拖延很长时间的方法。
BACKGROUND: Oral cancer is one of the ten most common malignancies in the world and approximately 90 % of cases are OSCC. Despite the progress in available treatment modalities, the mortality of patients with OSCC has remained steadily high during the last 20 years. Survival data is strongly influenced by the timing of diagnosis: with more than 50 % of patients being diagnosed at an advanced stage, and their 5-year survival rate being less than 50 %. Therefore, early diagnosis plays a crucial role in improving a patient\'s prognosis, as early stage cancers show a survival rate of over 90 %, whereas it drops to 5-20 % stage III and IV disease. This prospective study has been conducted with an aim of assessing diagnostic delays and looking at the various patient and tumour factors and their association with them.
METHODS: This prospective observational study was conducted from December 2023 to February 2024. The cases for the present study included cases of oral squamous cell carcinoma diagnosed by clinical, radiological and/or histological confirmation. The patient delay was recorded in days as informed by the patients themselves, about the onset of their symptoms to time taken to seek medical attention. This was then associated with various patient and tumour related factors.
RESULTS: A total of 120 (n) patients were interviewed and these patient\'s case sheets were recruited for the present study. The median primary delay for the entire population was found to be 90 days while the median secondary delay was 11 days. The median total delay was found to be 106 days. The median total delay was higher among females and younger population though this was not statistically significant. However education showed a significant impact with literate patients presenting much earlier. Smoking and alcohol abuse did not show a significant effect on delay. Various tumour factors also did not show any statistically significant effect on delay although, patients with advanced stage and nodal secondaries presented at a much later time.
CONCLUSIONS: Both patient and tumour related factors as well as the decisions made during the first contact with health care providers influence delay before specialist consultation. Raising awareness of HNC symptoms among the general population and GPs is the way to get patients to curative treatment without long delay.