Câncer de pulmão e retardo no diagnóstico: análise de 300 casos / Lung cancer and the delay in the diagnosis: analysis of 300 cases

RESUMO

This is a prospective study involving 300 persons with lung cancer admitted to the "Arnaldo Vieira de Carvalho" Cancer Institute (ICAVC). The intention of the survey was to detect delay in diagnosis after the initial symptoms. THe authors tried to identify causes of this delay and its implications. Patients were asked about the day that the symptoms started, medical care and specialists sought, number of physicians seen and their diagnosis, also examinations carried out and referrals. Results showed that 78 of cases were seen firstly by general practitioners and 69.6 looked for medical assistance at least 30 days after the clinical beginning of the disease. Chest X-rays could identify only 9 cases (3) without symptoms. The most common clinical diagnoses were pneumonia (20), neoplasia (19), bronchitis/emphysema (9.3) and tuberculosis (8). The number of first appointments seen by the Public Health Services and Contracted Private Hospital Network was 64.1 and the second appointment was 70. Only 24 (8) of the patients were referred to ICAVC just after their first appointment and 64.4 after the third. The time lost between the first appointment and the diagnosis was longer than 90 days in 55.7 of cases. These people needed to see 3 to 4 doctors (as an average) to obtain a positive diagnosis. The diagnostic techniques used more frequently were bronchoscopy (59.7) and fine needle lung biopsy (18.4) and the delay was 20 and 10 days on average, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)