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Symptom Interval and Patient Delay Affect Survival Outcomes in Adolescent Cancer Patients.

 Song Lee Jin  ;  Seung Min Hahn  ;  Hyo Sun Kim  ;  Yoon Jung Shin  ;  Sun Hee Kim  ;  Yoon Sun Lee  ;  Chuhl Joo Lyu  ;  Jung Woo Han 
 Yonsei Medical Journal, Vol.57(3) : 572-579, 2016 
Journal Title
 Yonsei Medical Journal 
Issue Date
Adolescent ; Child ; Delayed Diagnosis* ; Female ; Humans ; Male ; Multivariate Analysis ; Neoplasms/classification ; Neoplasms/diagnosis* ; Neoplasms/mortality* ; Neoplasms/psychology ; Patient Acceptance of Health Care/statistics & numerical data* ; Retrospective Studies ; Survival Analysis ; Survival Rate ; Time Factors
Adolescent cancer patients ; patient delay ; symptom interval
PURPOSE: Unique features of adolescent cancer patients include cancer types, developmental stages, and psychosocial issues. In this study, we evaluated the relationship between diagnostic delay and survival to improve adolescent cancer care. MATERIALS AND METHODS: A total of 592 patients aged 0-18 years with eight common cancers were grouped according to age (adolescents, ≥10 years; children, <10 years). We retrospectively reviewed their symptom intervals (SIs, between first symptom/sign of disease and diagnosis), patient delay (PD, between first symptom/sign of disease and first contact with a physician), patient delay proportion (PDP), and overall survival (OS). RESULTS: Mean SI was significantly longer in adolescents than in children (66.4 days vs. 28.4 days; p<0.001), and OS rates were higher in patients with longer SIs (p=0.001). In children with long SIs, OS did not differ according to PDP (p=0.753). In adolescents with long SIs, OS was worse when PDP was ≥0.6 (67.2%) than <0.6 (95.5%, p=0.007). In a multivariate analysis, adolescents in the long SI/PDP ≥0.6 group tended to have a higher hazard ratio (HR, 6.483; p=0.069) than those in the long SI/PDP <0.6 group (HR=1, reference). CONCLUSION: Adolescents with a long SI/PDP ≥0.6 had lower survival rates than those with a short SI/all PDP or a long SI/PDP <0.6. They should be encouraged to seek prompt medical assistance by a physician or oncologist to lessen PDs.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
김선희(Kim, Sun Hee)
김효선(Kim, Hyo Sun)
유철주(Lyu, Chuhl Joo) ORCID logo https://orcid.org/0000-0001-7124-7818
이윤선(Ree, Yoon Sun)
진송이(Jin, Song Lee)
한승민(Hahn, Seung Min) ORCID logo https://orcid.org/0000-0001-9832-6380
한정우(Han, Jung Woo) ORCID logo https://orcid.org/0000-0001-8936-1205
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