Document Detail


Time spans from first symptom to treatment in patients with lung cancer--the influence of symptoms and demographic characteristics.
MedLine Citation:
PMID:  17882556     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cancer stage at diagnosis is the most important prognostic factor for lung cancer (LC), but most patients are diagnosed with advanced disease with many and intense symptoms. This study explores relationships between LC patients' first symptoms, symptoms triggering health care system (HCS) contact, demographic/clinical characteristics, and time spans in the care trajectory from first symptom(s) to treatment start. MATERIALS AND METHODS: Medical records were examined from all 314 patients diagnosed with primary LC in 2003 at a Department of Respiratory Medicine, in Stockholm Sweden. Descriptive analysis was used to examine symptoms and time spans in the care trajectory. Cox regression analysis was conducted to explore the influence of symptoms and demographic/clinical characteristics on the time spans. RESULTS: Tumor-specific symptoms led to HCS visits to a greater extent than did systemic symptoms, despite reports of weight loss, fatigue and appetite loss as common first symptoms. Minor differences between women and men were found regarding specific symptoms. The study confirms that the time spans from first symptoms reported to treatment start are extensive, exceeding Swedish national recommendations. A lump/resistance, neurological symptoms, appetite loss, hemoptysis and non-thoracic related pain were associated with significantly shorter time spans in the care trajectory. People >74 years old risked longer time span from first HCS visit to treatment start. CONCLUSION: This study indicates a need for a more efficient LC care trajectory. Elderly patients could be particularly vulnerable for longer time spans.
Authors:
Malin Lövgren; Helena Leveälahti; Carol Tishelman; Sara Runesdotter; Katarina Hamberg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta oncologica (Stockholm, Sweden)     Volume:  47     ISSN:  1651-226X     ISO Abbreviation:  Acta Oncol     Publication Date:  2008  
Date Detail:
Created Date:  2008-08-14     Completed Date:  2008-10-09     Revised Date:  2009-05-12    
Medline Journal Info:
Nlm Unique ID:  8709065     Medline TA:  Acta Oncol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  397-405     Citation Subset:  IM    
Affiliation:
The Department of Neurobiology, Care Sciences and Society, Division of Nursing Karolinska Institutet, 141 83 Huddinge, Sweden. malin.lovgren@ki.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Anorexia / etiology
Chest Pain / etiology
Cough / etiology
Dyspnea / etiology
Early Diagnosis
Educational Status
Fatigue / etiology
Female
Hemoptysis / etiology
Humans
Lung Neoplasms / diagnosis,  epidemiology*,  psychology,  therapy
Male
Marital Status
Middle Aged
Patient Acceptance of Health Care / statistics & numerical data*
Proportional Hazards Models
Referral and Consultation / statistics & numerical data
Smoking / epidemiology
Sweden / epidemiology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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