Potential factors associated with clinical stage of nasopharyngeal carcinoma at diagnosis:a case–control study

摘要:

Background: In China, most patients with nasopharyngeal carcinoma (NPC) are diagnosed at a late stage and con-sequently have a poor prognosis. This study aimed to investigate potential factors associated with the clinical stage of NPC at diagnosis. Methods: Data were obtained from 118 patients with early-stage NPC and 274 with late-stage NPC who were treated at Sun Yat-sen University Cancer Center between August 2014 and July 2015. Patients were individually matched by age, sex, and residence, and a conditional logistic regression model was applied to assess the associa-tions of clinical stage at diagnosis with socioeconomic status indicators, knowledge of NPC, physical examinations, patient interval, and risk factors for NPC. Results: Although knowledge of early NPC symptoms, smoking cessation, and patient interval were important fac-tors, the number of cigarettes smoked per day, motorbike ownership, and physical examination exhibited the strong-est associations with the clinical stage of NPC at diagnosis. Compared with smoking fewer than ten cigarettes a day, smoking 10–30 cigarettes [odds ratio (OR) 4.03; 95% confidence interval (CI) 1.11–14.68] or more than 30 cigarettes (OR 11.46; 95% CI 1.26–103.91) was associated with an increased risk of late diagnosis. Compared with not owning a motorbike, owning a motorbike (OR 0.38; 95% CI 0.23–0.64) was associated with early diagnosis. Subjects who under-went physical examinations were less likely to receive a late diagnosis than those who did not undergo examinations (OR 0.50; 95% CI 0.28–0.89). However, indicators of wealth were not significant factors. Conclusions: Initiatives to improve NPC patient prognosis should aim to promote knowledge about early symptoms and detection, health awareness, and accessibility to health facilities among all patients, regardless of socioeconomic status.

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作者单位: School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, P. R. China [1] State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Rd, Guangzhou 510060, Guangdong, P. R. China [2] School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, P. R. China;State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng East Rd, Guangzhou 510060, Guangdong, P. R. China [3]
期刊: 《癌症(英文版)》2017年36卷10期 478-487页 ISTICCA
栏目名称: Original Article
DOI: 10.1186/s40880-017-0239-y
基金项目:
the National Science Fund for Distinguished Young Scholars of China the Key Project for International Cooperation and Exchange of the National Natural Science Foundation of China
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