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首页> 外文期刊>European journal of gastroenterology and hepatology >Determinants of patient's and doctor's delay in diagnosis and treatment of colorectal cancer.
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Determinants of patient's and doctor's delay in diagnosis and treatment of colorectal cancer.

机译：影响大肠癌诊断和治疗的患者和医生延迟的决定因素。

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BACKGROUND: Early detection and treatment is important for the management of colorectal cancer (CRC). AIM: To assess patient and doctor delay and their determinants. METHODS: A retrospective observational study in a primary care setting concerning 197 patients with CRC. The time between initial symptoms and the onset of treatment was categorized into four periods. With multivariable logistic regression analysis, determinants of delay were investigated. RESULTS: The median time from onset of symptoms until the start of treatment was 138 days. Median time for the four periods to: first general practitioner consult, first specialist consult, histological diagnosis, and start treatment were 30, 14, 27, and 18 days, respectively. Rectal blood loss and weight loss were significantly related to patient delay, whereas psychiatric comorbidity was related to delay in referral by the general practitioner. For delay in histological diagnosis and start of definitive treatment no determinants were found. Delay was not associated with more advanced disease stages. CONCLUSION: There is considerable delay in the management of CRC, especially in time to consultation and time to onset of clinical treatment. Education among the general public about the importance of alarm symptoms and increasing efficiency of the diagnostic process in hospital setting are a key in improving CRC disease management.
机译：背景：早期发现和治疗对结直肠癌（CRC）的管理很重要。目的：评估患者和医生的延误及其决定因素。方法：在一项初级保健机构中对197例CRC患者进行回顾性观察研究。从最初症状到开始治疗的时间分为四个时期。通过多变量logistic回归分析，研究了延迟的决定因素。结果：从症状发作到开始治疗的中位时间为138天。下列四个时期的中位数时间分别是30天，14天，27天和18天，这是第一位全科医生咨询，第一位专家咨询，组织学诊断和开始治疗的时间。直肠失血和体重减轻与患者延误显着相关，而精神病合并症与全科医生转诊延误有关。对于组织学诊断的延迟和确定性治疗的开始，未发现任何决定因素。延迟与更晚期的疾病阶段无关。结论：CRC的治疗有相当大的延迟，特别是在咨询时间和开始临床治疗的时间。公众对警报症状的重要性和医院环境中诊断过程的效率提高的教育是改善CRC疾病管理的关键。

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