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Time spans from first symptom to treatment in patients with lung cancer: The influence of symptoms and demographic characteristics
The Department of Neurobiology, Care Sciences and Society, Division of Nursing Karolinska Institutet, 141 83 Huddinge, Sweden. (The Department of Health and Social Sciences, Högskolan Dalarna, 791 88, Falun, Sweden)
The Department of Neurobiology, Care Sciences and Society, Division of Nursing Karolinska Institutet, 141 83 Huddinge, Sweden. (Stockholms Sjukhem Foundation, Research & Development Unit/Palliative Care, Mariebergsgatan 22, 112 35, Stockholm, Sweden)
Stockholms Sjukhem Foundation, Research & Development Unit/Palliative Care, Mariebergsgatan 22, 112 35, Stockholm, Sweden. (School of Nursing, Midwifery and Social work, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom and The Department of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, Berzelius väg 3, 171 77, Stockholm, Sweden)
The Department of Neurobiology, Care Sciences and Society, Division of Nursing Karolinska Institutet, 141 83 Huddinge, Sweden. (Stockholms Sjukhem Foundation, Research & Development Unit/Palliative Care, Mariebergsgatan 22, 112 35, Stockholm, Sweden)
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2008 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 47, no 3, 397-405 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2008. Vol. 47, no 3, 397-405 p.
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Cancer and Oncology Gender Studies
Identifiers
URN: urn:nbn:se:umu:diva-6936DOI: 10.1080/02841860701592392PubMedID: 17882556OAI: oai:DiVA.org:umu-6936DiVA: diva2:146606
Available from: 2008-10-23 Created: 2008-10-23 Last updated: 2016-01-01

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Hamberg, Katarina

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