oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2024-23-3-106-114oncotomsk-3120Research ArticleОПЫТ РАБОТЫ ОНКОЛОГИЧЕСКИХ УЧРЕЖДЕНИЙONCOLOGY PRACTICEВлияние социального статуса больного и организации системы здравоохранения на задержку диагностики и начала лечения рака пищеводаFactors of cancer diagnosed family and medical system for delay in diagnosis and treatment of esophageal cancerhttps://orcid.org/0000-0002-6238-1705KhanI. MajeedKhanI. Majeed

Imran Majeed Khan, Msc, MPhil, PhD, Consultant Physicist, ведущий научный сотрудник отдела радиационной онкологии

 Лахор 

Imran Majeed Khan, Msc, MPhil, PhD, Consultant Physicist, Leading Researcher, Radiation oncology Department

Lahore

bisimran@gmail.comHussainМ.HussainM.

Mazhar Hussain, MBBS, FCPS, консультант, лучевой терапевт, AIMC/радиационной онкологии

Лахор

Mazhar Hussain, MBBS, FCPS, Consultant Radiation oncology AIMC/Radiation oncology

Lahore 

LatifА.LatifA.

Anwar Latif, кандидат наук, профессор, заведующий кафедрой физики

Лахор

Anwar Latif, PhD, Professor, Head of Physics Department

Lahore 

SarwarА.SarwarA.

Amina Sarwar, научный сотрудник физического факультета

Лахор

Amina Sarwar, Researcher, Physics Department

Lahore 

Научно-исследовательский институт онкологии, Медицинский колледж Аллама Икбал/Больница ДжиннаПакистанCancer Research Institute, Allama Iqbal medical College/Jinnah HospitalPakistanБольница ДжиннаПакистанJinnah hospitalPakistanИнженерно-технологический университетПакистанUniversity of Engineering and TechnologyPakistan202406072024233106114Copyright © Khan I., Hussain М., Latif А., Sarwar А., 20242024Khan I., Hussain М., Latif А., Sarwar А.Khan I., Hussain M., Latif A., Sarwar A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/3120

Введение. Выявление рака пищевода на ранней стадии позволяет добиться благоприятного прогноза. Причины, препятствующие ранней диагностике рака, ускоряют прогрессирование заболевания. Цель исследования – изучить причины несвоевременной диагностики рака пищевода и составить график продолжительности этого процесса. Материал и методы. Исследование проводилось в больнице имени Джинна, Лахор, в больнице Медицинского колледжа Аллама Икбал, с июля 2019 по июль 2020 г. Среди пациентов было 49,42 % женщин и 50,57 % мужчин. Результаты. Средний возраст составил 56 лет, среднее время задержки диагностики – 206 дней, медиана – 197 дней, 25-й и 75-й процентили – 157 и 246 соответственно. Самые длительные задержки диагностики обнаружены в возрастной группе 51–60 лет, имевшие статистическую значимость (r=0,94; p=0,0004). Первоначальный симптом потери веса демонстрирует максимальную задержку диагностики (r=0,94; p=0,004). В группе пациентов с низким доходом выявлена максимальная задержка обращения к врачу, среднее – 142 дня, медиана – 135 дней, 25-й и 75-й процентили – 88 и 195 соответственно. Среднее значение времени задержки врача – 20 дней, медиана – 18 дней, 25-й и 75-й процентили – 16 и 23 соответственно. Среднее время задержки начала лечения – 18, медиана – 18,52 дня, 25-й и 75-й процентили – 14 и 22 соответственно. Образование пациентов значимо сокращает время задержки диагностики (r=0,91; p=0,02). Среднее время задержки, связанное с системой здравоохранения, составило 25 дней, медиана – 24 дня, 25-й и 75-й процентили – 20, 31. Заключение. Низкий образовательный уровень, финансовые проблемы, недоступность информации, касающейся рака и системы здравоохранения, а также ограниченное количество медицинских учреждений остаются основными причинами несвоевременной диагностики и начала лечения рака пищевода.

Introduction. The esophagus cancer patients needs early diagnosis to achieve better prognosis. The delay barriers increase progression of diseases to higher stages. The aim of work was to identify and explore the barriers in diagnosis of esophagus cancer and chart the time duration in this process. Material and Methods. The study was conducted in Jinnah Hospital Lahore (JHL), a teaching care hospital of Allama Iqbal Medical College, during a period of one year from July 2019 to July 2020. There were 49.42 % female and 50.57 % male patients. Results. Mean age found to be 56 years. Mean Total delay (TD ) time was 206 days and median Total delay (TD ) time in days were 197 days with 25th and 75th (157, 246) percentiles respectively. Longest delays were found in 51–60 age group and age related (r=0.94) significantly to delays (p=0.0004). Initial symptom of weight loss shows maximum delay and symptoms are highly correlated (r=0.94) with delay (p=0.004). The low income group presents maximum delay. Mean patient delay (PD ) time in days were 142 days with 135 Median and (88, 195) 25th and 75th percentile respectively. Mean, Median, 25th and 75th percentiles for Physician delays (PhyD) times were (20, 18, 16, 23) respectively. Treatment delay (TD ) time (Mean, Median) in days were (18, 18.52) with 25th and 75th (14, 22) percentiles. The education significantly reduces the delays with correlation (r=0.91) and significance (p=0.02). Mean system delay (SD ) time were 25 days and median were 24 days with 25th and 75th (20, 31) percentiles. Conclusion. Illiteracy, financial problems, and unavailability of information related to the cancer and health care system, very limited number of health facilities remains the main causes of these delays.

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The authors declare that there are no conflicts of interest present.