Family Practice Advance Access originally published online on July 8, 2005
Family Practice 2005 22(5):554-559; doi:10.1093/fampra/cmi058
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Patient factors associated with delay in primary care among patients with head and neck carcinoma: a case-series analysis
a Julius Center for Health Sciences and Primary Care, Section Medical and Health Psychology, STR.3.107, University Medical Center Utrecht, PO Box 85060, 3508 AB Utrecht and b Department of Otorhinolaryngology, University Medical Center Utrecht, PO Box 85060, 3508 GA Utrecht, The Netherlands
Correspondence to Debbie Tromp; Email: d.m.tromp{at}med.uu.nl
Background. Head and neck cancer patients are often diagnosed with advanced stage disease, while the location is easily accessible for examination or distinct symptoms are present. Professional delay in primary care affects tumour stage and survival. There has been little research on the role of the patient in delaying referral or diagnosis once the patient has visited a primary health care professional.
Objectives. Our aim was to identify patient-related factors which are associated with delay in primary care and the referral to hospital.
Methods. Case-series analysis using semi-structured interviews combined with questionnaires was conducted among 306 consecutive patients newly diagnosed in a tertiary referral centre for head and neck oncology patients in The Netherlands. The main outcome measure was delay in returning to the GP or dentist after the first consultation. Logistic regression analyses were performed to test which patient-related variables made delay more likely.
Results. 155 patients (53%) were not referred or followed up after the first medical contact with the GP or dentist. Fifty per cent (n = 78) of them delayed returning to the health professional for more than three weeks. Patients were more likely to delay when they experienced voice change, were not familiar with head and neck cancer, were not suspicious of cancer or were generally not inclined to seek support.
Conclusions. Delay in returning to the health professional is partly dependent on patient-related factors. Therefore, patients should be educated about the possible meaning and expected time-course of the symptoms and be strongly advised to return, or be followed up, within three to four weeks if the symptoms do not disappear.
Keywords. Diagnostic delay, head and neck carcinoma, referral.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  O.-P. Alho, H. Teppo, P. Mantyselka, and S. Kantola Head and neck cancer in primary care: presenting symptoms and the effect of delayed diagnosis of cancer cases. Can. Med. Assoc. J., March 14, 2006; 174(6): 779 - 784. [Abstract] [Full Text] [PDF]
|
|