预测症状性乳腺癌延迟呈现的因素:系统性审查
A J Ramirez1, A M Westcombe, C C Burgess
1ICRF Psychosocial Oncology Group, Guy's, King's and St Thomas's School of Medicine, Riddell House, St Thomas' Hospital, London, UK.
Lancet (London, England)
|April 21, 1999
概括
了解影响乳腺癌诊断延迟的因素至关重要. 年龄较大增加了患者的延迟,而年龄较小和非块症状增加了提供者延迟,但证据质量较低.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 症状性乳腺癌的延迟诊断与生存率的降低有关.
- 识别导致诊断延迟的因素对于制定有效的干预策略至关重要.
- 本系统性审查评估了有关患者和提供者延迟乳腺癌呈现的风险因素的证据.
研究的目的:
- 系统地审查和评估有关患者和提供者延迟乳腺癌诊断风险因素的证据的质量和强度.
- 为了确定与延迟呈现相关的特定的人口和临床因素.
主要方法:
- 关于延迟风险因素的假设生成,与已识别的研究进行测试.
- 对患者 (n=86) 和提供者 (n=28) 延迟的原始数据进行系统的文献搜索.
- 对研究进行批判性评估,以包括和评估证据的强度,因为有限的高质量研究阻止了元分析.
主要成果:
- 大多数审查的研究质量不佳;23项符合纳入标准.
- 强有力的证据将老年与患者的延迟联系在一起,并且没有发现与婚姻状况的关联.
- 年龄较小和非块乳腺症状是提供者延迟的强有力的风险因素;对于其他因素存在中度证据.
结论:
- 目前的证据质量不足以指导制定有针对性的策略,以减少患者或提供者延误.
- 迫切需要进行初级研究,以澄清发现,并为及时诊断乳腺癌的干预措施提供信息.
相关概念视频
Tumor Progression
Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
Assessment of the Rectum and Anus
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Cancer Survival Analysis
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
