The study of the characteristics of the interval from the first symptom to the diagnosis of cancer is influenced by the way in which the patient perceives and refers the appearance of the initial signs and symptoms. The aim of this study was to analyze the factors influencing this perception. Sixty-eight symptomatic patients with malignant neoplasm of the digestive tract, hospitalized in the Hospital del Mar in Barcelona were interviewed with a standardized questionnaire. The time of appearance of all the symptomatology was one week in 36% of the patients, equal to or less than one month in 53%, and equal to or less than 3 months in 75% of the cases. Seventy-six percent of the patients went to the physician on appearance of the first symptom. The symptoms of greatest frequency leading to the first medical consultation for the neoplastic process were hemorrhage, and symptoms occuring in a sudden, violent way, while the symptoms least associated to the first visit were abdominal pain and anorexia. The initial symptom was only associated to a new, severe disease in 5 cases, with 61% report not having attributed importance to the first symptoms, 15% associating the same with another previous disease, and 17% associating the initial symptom to a new yet mild disease. Female patients referred a mean of 4 symptoms versus 2 in males (p<0.04). Although the number of symptoms was slightly higher in non smoking patients and in those with stomach cancer, no relation was found with either the level of education or the degree of neoplastic dissemination. The first symptoms induced by cancerous disease are not usually related with a severe situation by the patient thus delaying diagnosis. Symptom perception by patients, as well as the way in which these symptoms are communicated should be taken into account.
|Publication status||Published - 1 Jan 1994|