Delay in Diagnosis of Testicular Cancer; A Need for Awareness Programs
BACKGROUND AIM:
To
gain insight into patient and doctor delay in testicular cancer (TC) and
factors associated with delay.
MATERIALS AND METHODS:
Sixty
of the 66 eligible men; median age 26 (range 17-45) years, diagnosed with TC at
the University Medical Center Groningen completed a questionnaire on patients'
delay: interval from symptom onset to first consultation with a general
practitioner (GP) and doctors' delay: interval between GP and specialist visit.
RESULTS:
Median
patient reported delay was 30 (range 1-365) days. Patient delay and TC tumor
stage were associated (p = .01). Lower educated men and men embarrassed about
their scrotal change reported longer patient delay (r = -.25, r = .79
respectively). Age, marital status, TC awareness, warning signals, nor
perceived limitations were associated with patient delay. Median patient
reported time from GP to specialist (doctors' delay) was 7 (range 0-240) days.
Referral time and disease stage were associated (p = .04). Six patients never
reported a scrotal change. Of the 54 patients reporting a testicular change, 29
(54%) patients were initially 'misdiagnosed', leading to a median doctors'
delay of 14 (1-240) days, which was longer (p< .001) than in the 25 (46%)
patients whose GP suspected TC (median doctors' delay 1(0-7 days).
CONCLUSIONS:
High
variation in patients' and doctors' delay was found. Most important risk
variables for longer patient delay were embarrassment and lower education. Most
important risk variable in GP's was 'misdiagnosis'. TC awareness programs for
men and physicians are required to decrease delay in the diagnosis of TC and
improve disease free survival.
- 1Department of Surgical Oncology, University of Groningen, University Medical Center, Groningen, the Netherlands.
- 2Department of Health Psychology, University of Groningen, University Medical Center, Groningen, the Netherlands.
- 3Wenckebach Institute, University of Groningen, University Medical Center, Groningen, the Netherlands.
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