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  • 1 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Onkoterápiás Intézet, Pécs
  • 2 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Alapellátási Intézet, Pécs, Rákóczi út 2., 7624
  • 3 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Orvosi Népegészségtani Intézet, Pécs

Összefoglaló.Bevezetés: Az európai országok közül Magyarország a colorectalis daganatos incidencia és mortalitás szempontjából az élen szerepel. Ennek hátterében a beteghez vagy az egészségügyi rendszerhez köthető tényezők is állhatnak. Célkitűzés: Kutatásunk célja, hogy pilotvizsgálat keretében feltárjuk a colorectalis daganatos betegek kezeléshez jutásának körülményeit azáltal, hogy a betegek első tünetei, kivizsgálásuk jellemzői, betegségük stádiuma és a terápiáig eltelt időtartamok közötti összefüggéseket elemezzük. Módszer: Retrospektív adatgyűjtés történt 26, Baranya megyei háziorvosi praxis colorectalis daganatos betegeinek (n = 212) adataira vonatkozóan a praxisok, valamint a Pécsi Tudományegyetem Klinikai Központjának (PTE KK) adatbázisából. Meghatároztuk a terápiáig eltelt intervallumot (TEI), amely az első orvos-beteg találkozástól – amikor a beteg colorectalis daganatra utaló tünetekkel először jelentkezett orvosnál – a terápia megkezdésének első napjáig eltelt időt jelenti. A statisztikai elemzés során deskriptív analízist, valamint varianciaanalízist végeztünk. Eredmények: A sürgősségire került betegek leggyakoribb tünete a hasi/végbéltáji fájdalom volt, míg a háziorvost felkereső betegek a véres székletet említették a legtöbbször. A sürgősségi osztályon jelentkező betegek esetében lényegesen magasabb arányban (61%) diagnosztizáltak késői (III–IV.) stádiumú daganatot, mint a háziorvoshoz forduló betegek körében (42,7%). A TEI rövidebb volt, ha a betegek sürgősségi osztályra kerültek (TEI-medián: 15 nap késői, 34,5 nap korai [I–II.] stádiumú daganat esetén), mint amikor háziorvosnál jelentkeztek először (TEI-medián: 86 nap késői, 83 nap korai stádiumú daganat esetén). Következtetés: A sürgősségi és a háziorvosi kivizsgálás esetén észlelt TEI-k összemérhetők a nyugat-európai országokéival. A hazai magas mortalitási mutatók hátterében inkább a betegek késedelmes orvoshoz fordulása állhat, ami a primer és szekunder prevenció fontosságára hívja fel a figyelmet. Orv Hetil. 2021; 162(4): 153–160.

Summary. Introduction: Hungary has one of the leading colorectal cancer incidence and mortality rates in Europe. Patient-related and healthcare-related factors may all play a role. Objective: Our objective was to investigate the characteristics related to the treatment of colorectal cancer patients by analysing their initial symptoms, disease stage, referral characteristics and total treatment intervals. Method: A retrospective study was conducted based on data from colorectal patients (n = 212) from the databases of 26 general physician practices and the University of Pécs, Clinical Center. The total treatment interval was determined as the number of days from the first patient-physician consultation with symptoms until the first day of treatment. Descriptive analysis and analysis of variance were performed. Results: Patients’ most common symptom was abdominal/rectal pain when presenting at the emergency department while bloody stool was the most common among patients visiting their general physicians. The proportion of patients with advanced stage (III–IV) cancer was significantly higher at the emergency department than among patients visiting their general physicians (61% and 42.7%, respectively). The total treatment interval was shorter when patients presented at the emergency department (total treatment interval median: 15 days for advanced stage, 34.5 days for early [I–II] stage cancer) than when they initially visited their general physicians (total treatment interval median: 83 days for early stage, 86 days for advanced stage cancers). Conclusion: The total treatment intervals for patients visiting the emergency department or their general physicians were similar to those found in Western European countries. The high mortality rates in Hungary are more probably due to patient-related delays, which highlight the importance of primary and secondary prevention. Orv Hetil. 2021; 162(4): 153–160.

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