Journal Information
Vol. 39. Issue 4.
Pages 167-170 (April 2003)
Share
Share
Download PDF
More article options
Vol. 39. Issue 4.
Pages 167-170 (April 2003)
Full text access
Duración de la valoración diagnóstica del cáncer de pulmón frente a otros tumores sólidos en el Instituto Oncológico Nacional de Ecuador
Duration of the diagnostic process for lung cancer versus other solid tumors at the National Oncology Institute of Ecuador
Visits
8283
A.X. Freirea,
Corresponding author
afreire@utmem.edu

Correspondencia: Associate Professor of Medicine & Preventive Medicine. Uthsc-College of Medicine-Memphis, Coleman Bldg.956 Court Ave, Room H-314. Memphis, TN 38163. USA
, S. Benítezb, K. Brionesb, N.V. Freireb
a Servicio de Neumología, Terapia Respiratoria y Cuidados Intensivos. The Regional Medical Center.Universidad de Tennessee Health Science Center. Memphis, TN. EE.UU
b Servicio de Neumología. Instituto Oncológico Nacional Dr. Juan Tanca Marengo (Ion-Solca). Guayaquil. Ecuador
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Objetivo

Determinar la duración del proceso diagnóstico del cáncer (pulmón frente a tumores de órganos sólidos/todos) en el ION-SOLCA utilizando la modalidad de evaluación ambulatoria

Población Y Métodos

La totalidad de los pacientes con cáncer de pulmón de células no pequeñas (CPCNP) evaluados durante el período comprendido entre el 1 de enero y el 31 de diciembre de 1995 en el ION-SOLCA de Guayaquil, Ecuador (hospital de referencia terciario), comparando con la duración de la evaluación diagnóstica de otras neoplasias de órganos sólidos en la institución

Diseño

Estudio retrospectivo de servicios de salud que cuantifica la duración de cada etapa del proceso diagnóstico de los pacientes con cáncer en el ION-SOLCA. Se consideró como variable índice del estudio la duración de la evaluación diagnóstica de los casos estudiados en el ION-SOLCA. Simultáneamente se obtuvo la duración de cada componente de la variable índice

Resultados

La duración media ± DE de la evaluación diagnóstica global en el ION-SOLCA para los tumores de órganos sólidos (pulmón y otros) es de 54,5 ± 62,3 días (error estándar [EE], 7,6). No se encontró diferencia entre los dos grupos. Los componentes de esta estimación se fraccionan del siguiente modo: primer contacto con el instituto (preadmisión)-visita con el especialista, 12,5 ± 11,4 días (EE, 1,4); visita con el especialista-procedimiento diagnóstico, 33,3 ± 57 días (EE, 7), y procedimiento diagnóstico-resultado de anatomía patológica, 8,7 ± 6,9 días (EE, 0,8)

Conclusiones

La valoración ambulatoria de los pacientes con alta probabilidad de cáncer es un proceso ineficiente, lento y posiblemente peligroso. Una modalidad de ingreso intervencionista podría acelerar el proceso diagnóstico en estos pacientes

Palabras clave:
Cáncer
Diagnóstico
Pulmón
Objective

To determine the duration of the outpatient diagnostic process for lung cancer in comparison to that of other solid organ tumors/all tumors at the National Oncology Institute-Society to Fight Cancer (ION-SOLCA) of Ecuador

Patients And methods

All patients with non-small cell lung cancer (NSCLC) seen between January 1 and December 31, 1995 at the ION-SOLCA, a specialized tertiary care hospital in Guayaquil, Ecuador, were studied. The duration of the patients' diagnostic process was compared to that of other patients with solid organ tumors (1 control per NSCLC patient)

Design

Retrospective study of health care services to measure the duration of each stage of the diagnostic process for cancer patients at the ION-SOLCA

Measures

The main variable was the duration of the diagnostic process. The duration of each phase of the process was also recorded

Results

Results are given as means (± standard deviations, with standard errors between parentheses). The overall duration of the diagnostic process for all solid organ tumors (lung and others) at the ION-SOLCA was 54.5 days ± 62.3 (7.6). No differences were detected between the duration of diagnosis for lung and other tumors. The durations of the different phases of diagnosis were as follows: from the first preadmission contact with the hospital until a visit with a specialist, 12.5 days ± 11.4 (1.4); from the visit with a specialist until a diagnostic procedure, 33.3 days ± 57 (7); and from the diagnostic procedure until the pathological diagnosis, 8.7 days ± 6.9 (0.8)

Conclusions

Outpatient evaluation is an inefficient, slow and potentially dangerous process in cases in which the probability of a cancer diagnosis is high. A more interventionist process involving hospital admission may accelerate diagnosis in such cases

Keywords:
Cancer
Lung
Diagnosis
Full text is only aviable in PDF
Bibliografía
[1.]
E. Robinson.
The fight against the delay in the diagnosis of cancer.
Biomed Pharmacother, 38 (1984), pp. 321-322
[2.]
K.A. Kern.
Medicolegal analysis of the delayed diagnosis of cancer in 338 cases in the United States.
Arch Surg, 129 (1994), pp. 397-403
[3.]
E.D. Christensen, T. Harvald, M. Jendresen, S. Aggestrup, G. Petterson.
The impact of delayed diagnosis of lung cancer on the stage at the time of operation.
Eur J Cardiothorac Surg, 12 (1997), pp. 880-884
[4.]
E. Robinson, J. Mohilever, J. Zidan, D. Sapir.
Colorectal cancer: incidence, delay in diagnosis and stage of disease.
Eur J Cancer Clin Oncol, 22 (1986), pp. 157-161
[5.]
E. Robinson, J. Mohilever, J. Zidan, D. Sapir.
Delay in diagnosis of cancer. Possible effects on the stage of disease and survival.
Cancer, 54 (1984), pp. 1454-1460
[6.]
J.W. Moul, D.F. Paulson, R.K. Dodge, P.J. Walther.
Delay in diagnosis and survival in testicular cancer: impact of effective therapy and changes during 18 years.
J Urol, 143 (1990), pp. 520-523
[7.]
J.M. Elwood, W.P. Moorehead.
Delay in diagnosis and long-term survival in breast cancer.
Br Med J, 280 (1980), pp. 1291-1294
[8.]
L.P. Casalino.
The unintended consequences of measuring quality on the quality of medical care.
N Engl J Med, 341 (1999), pp. 1147-1150
[9.]
J.R. Pereira, F.K. Ikari, H. Minamoto, J.C. Cassioli.
Delay factors in the diagnosis of lung cancer: a public health problem.
Rev Paul Med, 109 (1991), pp. 109-112
[10.]
G. Launoy, X. Le Coutour, M. Gignoux, D. Pottier, G. Dugleux.
Influence of rural environment on diagnosis, treatment, and prognosis of colorectal cancer.
J Epidemiol Community Health, 46 (1992), pp. 365-367
[11.]
H.W. Holliday, J.D. Hardcastle.
Delay in diagnosis and treatment of symptomatic colorectal cancer.
Lancet, 1 (1979), pp. 309-311
[12.]
J.L. Richardson, B. Langholz, L. Bernstein, C. Burciaga, K. Danley, R.K. Ross.
Stage and delay in breast cancer diagnosis by race, socioeconomic status, age and year.
Br J Cancer, 65 (1992), pp. 922-926
[13.]
T. Mikulin, J.D. Hardcastle.
Gastric cancer -delay in diagnosis and its causes.
Eur J Cancer Clin Oncol, 23 (1987), pp. 1683-1690
[14.]
K. Fiscella, P. Franks, M.R. Gold, C.M. Clancy.
Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care.
Jama, 283 (2000), pp. 2579-2584
[15.]
P.B. Bach, L.D. Cramer, J.L. Warren, C.B. Begg.
Racial differences in the treatment of early-stage lung cancer.
N Engl J Med, 341 (1999), pp. 1198-1205
[16.]
S. Dische, D. Gibson, M. Parmar, M.I. Saunders.
Time course from first symptom to treatment in patients with non-small cell lung cancer referred for radiotherapy: a report by the CHART Steering Committee.
Thorax, 51 (1996), pp. 1262-1265
[17.]
W.G. Shafer.
Initial mismanagement and delay in diagnosis of oral cancer.
J Am Dent Assoc, 90 (1975), pp. 1262-1264
[18.]
P.I. Tartter, D. Pace, M. Frost, J.L. Bernstein.
Delay in diagnosis of breast cancer.
Ann Surg, 229 (1999), pp. 91-96
[19.]
E.M. Smith, B. Anderson.
The effects of symptoms and delay in seeking diagnosis on stage of disease at diagnosis among women with cancers of the ovary.
Cancer, 56 (1985), pp. 2727-2732
[20.]
S. Franceschi, C. La Vecchia, G. Gallus, A. DeCarli, E. Colombo, C. Mangioni, et al.
Delayed diagnosis of endometrial cancer in Italy.
Cancer, 51 (1983), pp. 1176-1178
[21.]
H. Mitchell, G. Medley.
Delay times to definitive diagnosis after an abnormal Pap smear.
Aust N Z J Obstet Gynaecol, 27 (1987), pp. 283-286
[22.]
P.J. George.
Delays in the management of lung cancer.
Thorax, 52 (1997), pp. 107-108
[23.]
J.S. Billing, F.C. Wells.
Delays in the diagnosis and surgical treatment of lung cancer.
Thorax, 51 (1996), pp. 903-906
[24.]
M.A. Rahim, S.K. Sarma.
Pulmonary and extrapulmonary manifestations in delayed diagnosis of lung cancer in Bangladesh.
Cancer Detect Pre, 7 (1984), pp. 31-35
[25.]
A. López Encuentra, J.L. Martín de Nicolás, M. Casado López, E. De Miguel Poch, C. Marrón Fernández.
Retraso en el diagnóstico y tratamiento quirúrgico del carcinoma broncogénico. Grupo cooperativo en carcinoma broncogénico de SEPAR (GCCB-S).
Arch Bronconeumol, 34 (1998), pp. 123-126
[26.]
Oficina Panamericana de la Salud -pAHO/WHO World Health Organization [consultado 10/10/2002]. Disponible en:http://www.paho.org/English/SHA/coredata/tabulator/newsqlTabulador.asp
[27.]
Instituto Nacional de Estadísticas y Censo. Censo Ecuador 2001 [consultado 10/10/2002]. Disponible en:http://www.inec.gov.ec/
Copyright © 2003. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?