Ocena zamikov pri napotitvi, izvedbi diagnostike in prvega zdravljenja pri bolnikih z raki sečnega mehurja in ledvic v Sloveniji
Assessment of possible delays in referrals, diagnostics procedures and first treatment in Slovenian bladder and kidney cancer
DOI:
https://doi.org/10.25670/oi2020-001onKeywords:
kidney cancer, bladder cancer, referral, diagnostics, treatment, waiting times, national cancer control planAbstract
Pri nas za ledvičnim rakom na leto povprečno zboli 370 ljudi, za rakom sečnega mehurja 320. Preživetje slovenskih bolnikov in bolnic pri teh dveh oblikah raka je že vrsto let slabše od evropskega povprečja. V povezavi treh raziskovalnih organizacij, Onkološkega inštituta Ljubljana, Katedre za družinsko medicino Univerze v Ljubljani in Kliničnega oddelka za urologijo Univerzitetnega kliničnega centra Ljubljana, smo leta 2017 uvedli projekt Celostna analiza zgodnje obravnave bolnikov z urološkimi raki z oceno zamikov pri napotitvi, izvedbi diagnostike in prvega zdravljenja, v katerem smo retrospektivno analizirali zdravstveno oskrbo slovenskih bolnikov in bolnic z raki ledvic, sečnega mehurja ali prostate. V raziskavo smo vključili vse zbolele v Sloveniji leta 2014. V tem prispevku prikazujemo rezultate ocene zamikov v zdravljenju bolnikov in bolnic z rakom ledvic in rakom sečnega mehurja.
Median interval zdravstvenega sistema (čas od prvih preiskav do začetka zdravljenja) je bil pri bolnikih z rakom sečnega mehurja 35 dni, pri bolnikih z ledvičnim rakom pa 22 dni. Pri obeh rakih je največ časa poteklo med prvimi diagnostičnimi postopki in prvim pregledom pri specialistu, kar nakazuje na ozko grlo pri izvedbi diagnostičnih postopkov.
Abstract (Eng)
The average annual incidence of kidney cancer in Slovenia is 370, and the incidence of bladder cancer is 320. Consortium of three research organizations: the Institute of Oncology Ljubljana, Department of Family Medicine, University of Ljubljana and the Clinical Department of Urology at the University Clinical Center Ljubljana, launched the project Comprehensive analysis of management of urological cancer patients with an assessment of possible delays in referrals, realization of diagnostics procedures and first treatment in 2017. Its main objective was to retrospectively analyse the health care of Slovenian patients with cancer of the kidney, bladder or prostate. The study included all Slovenian patients diagnosed in 2014. This article presents the results of an assessment of delays in referrals, diagnostics procedures and first treatment in bladder and kidney cancer patients.
The median system interval (time from first examinations to initiation of treatment) was 35 days in patients with bladder cancer and 22 days in patients with kidney cancer. In both cases, the greatest amount of time elapsed between the first diagnostic procedures and the first specialist visit what points to a bottleneck in performing diagnostic procedures at both the primary and secondary levels of our health system.
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