错过的机会:65岁及以上女性宫癌查失败
Brandon I Ing1, Marla E Scott, Scott E Lentz
1Division of Gynecologic Oncology, Southern California Permanente Medical Group, Los Angeles, CA.
Journal of lower genital tract disease
|July 19, 2023
概括
许多被诊断为宫癌的老年妇女缺乏足够的查,错过了早期检测的机会. 适当的查显著提高了宫癌患者的生存率.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 预防医学 预防医学
背景情况:
- 子宫癌查指南旨在早期检测癌前病变和癌症.
- 建议在65岁后停止查,对于有足够的先前查的女性来说.
- 被诊断为宫癌的老年妇女往往有不充分的查史.
研究的目的:
- 评估65岁以后被诊断患有宫癌的妇女的查史和结果.
- 在这个人口群体中确定与充分查相关的因素.
- 评估查对宫癌诊断和生存率的影响.
主要方法:
- 在65岁后 (2012-2021) 被诊断患有子宫癌的妇女的回顾性队列研究.
- 数据提取包括人口统计,病史,查,病理学,随访和治疗.
- 统计分析包括千平方,逻辑回归和卡普兰-梅尔生存估计.
主要成果:
- 只有26.3%的符合条件的患者进行了适当的宫癌查.
- 41%的诊断患者死于他们的疾病.
- 长期管理护理组织 (MCO) 会员与查相关,但许多人仍然超过65岁,但没有达到戒断标准.
- 医生访问的增加与诊断的早期阶段相关.
- 在适当查的患者中,癌症特异性生存的中位数更高 (68个月与30个月相比).
结论:
- 在65岁以上的女性中,大多数宫癌病例发生,尽管先前查不足.
- 错过的查机会是常见的,即使有多个供应商的互动.
- 通过早期诊断,适当的查似乎会给生存带来好处.
- 需要进一步的研究来完善老年妇女的宫癌查停止标准.
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