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Publication Date: 2008-01-01
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Mesa Villegas JI, Jaramillo Ayerbe F, Benjumea Rincón MV. Factors related to late dermatological consultation for skin cancer. Test pilot. Department of Caldas. Hacia Promoc. Salud [Internet]. 2008 Jan. 1 [cited 2024 May 21];13:178-94. Available from: https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/1864
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Abstract
Researches conducted by the Universidad de Caldas reveal a tendency in late consultations to specialists regarding skin cancer. The purpose of this study is to identify the factors by which patients with skin cancer consult dermatologists so late, for the specific case of the department of Caldas. This was a retrospective descriptive study on 62 patients with skin cancer, treated at the Universidad de Caldas from January 2005 up to June 2007. The demographic, socioeconomic and behavioral characteristics of patients were studied, as well as the factors associated with the health system and the skin lesion. The results were described using average, standard deviation, minimum and maximum values, percentiles and relative frequencies. Differences between the delays were determined according to the characteristics of patients with the chi2 test, taking p<0.05 as a significant mark. The statistical analysis was performed with SPSS 15.0 software. The patient was identified as the main factor for delay in the consultation, highlighting factors such as: female gender, over 60 years of age, little schooling and welfare system. Most of them said they had not received prior information on the subject. While there is room for improvement in the various levels of health care, the predominant factor that could explain the late consultation of skin cancer is related to the patients characteristics and attitudes.
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References
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Rigel DS, Friedman RJ, Kopf AW, Polsky D. ABCDE- an evolving concept in the early detection of melanoma. Arch Dermatol, 2005; 141(8): 1032-4.
Boyle P, Dore JF, Autier P, Ringborg U. Cancer of the skin: a forgotten problem in Europe. Ann Oncol, 2004; 15(1): 5-6.
Housman TS, Feldman SR, Williford PM, Fleischer AB, Jr., Goldman ND, Acostamadiedo JM, et al. Skin cancer is among the most costly of all cancers to treat for the Medicare population. J Am Acad Dermatol, 2003; 48(3): 425-9.
Piñeros M, Pardo C, Cantor L, Hernández G, Martínez T, Pérez N, et al. Registro Institucional de cáncer del Instituto Nacional de Cancerología, Empresa Social del Estado. Resultados principales, año 2001. Revista Colombiana de Cancerología, 2002; 6(3): 4-49.
Santacoloma G, Jaramillo F. Comportamiento clínico, epidemiológico e histológico del carcinoma basocelular en Caldas. Colombia. Medicina Cutánea Ibero Latinoamericana, 1988; XXVI(98): 184-189.
Villegas M, Jaramillo F. Comportamiento clínico, epidemiológico e histológico del melanoma maligno en el departamento de Caldas, Colombia. Revista Asociación Colombiana de Dermatología y Cirugía Dermatológica, 1999; 7: 192-196.
Ospina J, Jaramillo F. Comportamiento clínico y epidemiológico de carcinoma cutáneo en el Hospital de Caldas de Manizales. Revista Asociación Colombiana de Dermatología y Cirugía Dermatológica, 1999; 7: 70-73.
Cassileth BR, Temoshok L, Frederick BE, Walsh WP, Hurwitz S, Guerry D, et al. Patient and physician delay in melanoma diagnosis. J Am Acad Dermatol, 1988; 18(3): 591-8.
Tyler I, Rivers JK, Shoveller JA, Blum A. Melanoma detection in British Columbia, Canada. J Am Acad Dermatol, 2005; 52(1): 48-54.
Reyes-Ortiz C, Goodwin J, Freeman J. The effect of socioeconomic factors on incidence, stage at diagnosis and survival of cutaneous melanoma. Med Sci Monit, 2005; 11(5): RA163-172.
Blum A, Brand CU, Ellwanger U, Schlagenhauff B, Stroebel W, Rassner G, et al. Awareness and early detection of cutaneous melanoma: an analysis of factors related to delay in treatment. Br J Dermatol, 1999; 141(5): 783-7.
Betti R, Vergani R, Tolomio E, Santambrogio R, Crosti C. Factors of delay in the diagnosis of melanoma. Eur J Dermatol, 2003; 13(2): 183-8.
Demers AA, Nugent Z, Mihalcioiu C, Wiseman MC, Kliewer EV. Trends of nonmelanoma skin cancer from 1960 through 2000 in a Canadian population. J Am Acad Dermatol, 2005; 53(2): 320-8.
Eide MJ, Weinstock MA, Dufresne RG, Jr., Neelagaru S, Risica P, Burkholder GJ, et al. Relationship of treatment delay with surgical defect size from keratinocyte carcinoma (basal cell carcinoma and squamous cell carcinoma of the skin). J Invest Dermatol, 2005; 124(2): 308-14.
Housman TS, Williford PM, Feldman SR, Teuschler HV, Fleischer AB, Jr., Goldman ND, et al. Nonmelanoma skin cancer: an episode of care management approach. Dermatol Surg, 2003; 29(7): 700-11.
Askari SK, Schram SE, Wenner RA, Bowers S, Liu A, Bangerter AK, et al. Evaluation of prospectively collected presenting signs/symptoms of biopsy-proven melanoma, basal cell carcinoma, squamous cell carcinoma, and seborrheic keratosis in an elderly male population. J Am Acad Dermatol, 2007; 56(5): 739-47.
Geller AC, Annas GD. Epidemiology of melanoma and nonmelanoma skin cancer. Semin Oncol Nurs, 2003; 19(1): 2-11.
Stang A, Ziegler S, Buchner U, Ziegler B, Jockel KH, Ziegler V. Malignant melanoma and nonmelanoma skin cancers in Northrhine-Westphalia, Germany: a patient- vs. diagnosis-based incidence approach. Int J Dermatol, 2007; 46(6): 564-70.
Tovar J, Carrasquilla H. Remisiones de médicos generales a dermatólogos. Revista Asociación Colombiana de Dermatología y Cirugía Dermatológica, 2005; 13(2): 116-119.
CEMIYÁ, Universidad del Valle, Secretaría de Salud Pública Municipal. Caracterización de la morbilidad materna extrema. Enero - Diciembre de 2005. Santiago de Cali: CEMIYÁ; Mayo de 2006.
Maine D, Akalin M, Ward V, Kamara A. Diseño y evaluación de programas para mortalidad materna. New York: Centro para la Población y Salud Familiar. Facultad de Salud Pública. Universidad de Columbia; 1997.
Gallego L, Gómez J, Escobar A. Modelos para el análisis de la mortalidad materna y perinatal. Primera ed. Medellín: Alcaldía de Medellín. Secretaría de Salud; 2005.
Baumert J, Plewig G, Volkenandt M, Schmid-Wendtner MH. Factors associated with a high tumour thickness in patients with melanoma. Br J Dermatol, 2007; 156(5): 938-44.
Carli P, De Giorgi V, Palli D, Maurichi A, Mulas P, Orlandi C, et al. Dermatologist detection and skin self-examination are associated with thinner melanomas: results from a survey of the Italian Multidisciplinary Group on Melanoma. Arch Dermatol, 2003; 139(5): 607-12.
Carli P, De Giorgi V, Giannotti B, Seidenari S, Pellacani G, Peris K, et al. Skin cancer day in Italy: method of referral to open access clinics and tumor prevalence in the examined population. Eur J Dermatol, 2003; 13(1): 76-9.
Brochez L, Verhaeghe E, Bleyen L, Naeyaert JM. Time delays and related factors in the diagnosis of cutaneous melanoma. Eur J Cancer, 2001; 37(7): 843-8.
Hennrikus D, Girgis A, Redman S, Sanson-Fisher RW. A community study of delay in presenting with signs of melanoma to medical practitioners. Arch Dermatol, 1991; 127(3): 356-61.
Kirsner RS, Wilkinson JD, Ma F, Pacheco H, Federman DG. The association of Medicare health care delivery systems with stage at diagnosis and survival for patients with melanoma. Arch Dermatol, 2005; 141(6): 753-7.
Lydiatt DD. Medical malpractice and cancer of the skin. Am J Surg, 2004; 187(6): 688-94.
Rhodes AR. Public education and cancer of the skin. What do people need to know about melanoma and nonmelanoma skin cancer? Cancer, 1995; 75(2 Suppl): 613-36.
Schmid-Wendtner MH, Baumert J, Stange J, Volkenandt M. Delay in the diagnosis of cutaneous melanoma: an analysis of 233 patients. Melanoma Res, 2002; 12(4): 389-94.
Swetter SM, Soon S, Harrington CR, Chen SC. Effect of health care delivery models on melanoma thickness and stage in a university-based referral center: an observational pilot study. Arch Dermatol, 2007; 143(1): 30-6.
Youl PH, Baade PD, Janda M, Del Mar CB, Whiteman DC, Aitken JF. Diagnosing skin cancer in primary care: how do mainstream general practitioners compare with primary care skin cancer clinic doctors? Med J Aust, 2007; 187(4): 215-20.
Temoshok L, DiClemente RJ, Sweet DM, Blois MS, Sagebiel RW. Factors related to patient delay in seeking medical attention for cutaneous malignant melanoma. Cancer, 1984; 54(12): 3048-53.
Rampen FH, Rumke P, Hart AA. Patients and doctors delay in the diagnosis and treatment of cutaneous melanoma. Eur J Surg Oncol, 1989; 15(2): 143-8.
Krige JE, Isaacs S, Hudson DA, King HS, Strover RM, Johnson CA. Delay in the diagnosis of cutaneous malignant melanoma. A prospective study in 250 patients. Cancer, 1991; 68(9): 2064-8.
Richard MA, Grob JJ, Avril MF, Delaunay M, Gouvernet J, Wolkenstein P, et al. Delays in diagnosis and melanoma prognosis (II): the role of doctors. Int J Cancer, 2000; 89(3): 280-5.
Richard MA, Grob JJ, Avril MF, Delaunay M, Gouvernet J, Wolkenstein P, et al. Delays in diagnosis and melanoma prognosis (I): the role of patients. Int J Cancer, 2000; 89(3): 271-9.
Silfen R, Amir A, Regev D, Hauben DJ. Role of physicians and patients in the diagnostic delay of cutaneous malignant melanoma. Ann Plast Surg, 2002; 49(4): 439-42.
Youl PH, Raasch BA, Janda M, Aitken JF. The effect of an educational programme to improve the skills of general practitioners in diagnosing melanocytic/pigmented lesions. Clin Exp Dermatol, 2007; 32(4): 365-70.
Rigel DS, Friedman RJ, Kopf AW, Polsky D. ABCDE- an evolving concept in the early detection of melanoma. Arch Dermatol, 2005; 141(8): 1032-4.
Boyle P, Dore JF, Autier P, Ringborg U. Cancer of the skin: a forgotten problem in Europe. Ann Oncol, 2004; 15(1): 5-6.
Housman TS, Feldman SR, Williford PM, Fleischer AB, Jr., Goldman ND, Acostamadiedo JM, et al. Skin cancer is among the most costly of all cancers to treat for the Medicare population. J Am Acad Dermatol, 2003; 48(3): 425-9.
Piñeros M, Pardo C, Cantor L, Hernández G, Martínez T, Pérez N, et al. Registro Institucional de cáncer del Instituto Nacional de Cancerología, Empresa Social del Estado. Resultados principales, año 2001. Revista Colombiana de Cancerología, 2002; 6(3): 4-49.
Santacoloma G, Jaramillo F. Comportamiento clínico, epidemiológico e histológico del carcinoma basocelular en Caldas. Colombia. Medicina Cutánea Ibero Latinoamericana, 1988; XXVI(98): 184-189.
Villegas M, Jaramillo F. Comportamiento clínico, epidemiológico e histológico del melanoma maligno en el departamento de Caldas, Colombia. Revista Asociación Colombiana de Dermatología y Cirugía Dermatológica, 1999; 7: 192-196.
Ospina J, Jaramillo F. Comportamiento clínico y epidemiológico de carcinoma cutáneo en el Hospital de Caldas de Manizales. Revista Asociación Colombiana de Dermatología y Cirugía Dermatológica, 1999; 7: 70-73.
Cassileth BR, Temoshok L, Frederick BE, Walsh WP, Hurwitz S, Guerry D, et al. Patient and physician delay in melanoma diagnosis. J Am Acad Dermatol, 1988; 18(3): 591-8.
Tyler I, Rivers JK, Shoveller JA, Blum A. Melanoma detection in British Columbia, Canada. J Am Acad Dermatol, 2005; 52(1): 48-54.
Reyes-Ortiz C, Goodwin J, Freeman J. The effect of socioeconomic factors on incidence, stage at diagnosis and survival of cutaneous melanoma. Med Sci Monit, 2005; 11(5): RA163-172.
Blum A, Brand CU, Ellwanger U, Schlagenhauff B, Stroebel W, Rassner G, et al. Awareness and early detection of cutaneous melanoma: an analysis of factors related to delay in treatment. Br J Dermatol, 1999; 141(5): 783-7.
Betti R, Vergani R, Tolomio E, Santambrogio R, Crosti C. Factors of delay in the diagnosis of melanoma. Eur J Dermatol, 2003; 13(2): 183-8.
Demers AA, Nugent Z, Mihalcioiu C, Wiseman MC, Kliewer EV. Trends of nonmelanoma skin cancer from 1960 through 2000 in a Canadian population. J Am Acad Dermatol, 2005; 53(2): 320-8.
Eide MJ, Weinstock MA, Dufresne RG, Jr., Neelagaru S, Risica P, Burkholder GJ, et al. Relationship of treatment delay with surgical defect size from keratinocyte carcinoma (basal cell carcinoma and squamous cell carcinoma of the skin). J Invest Dermatol, 2005; 124(2): 308-14.
Housman TS, Williford PM, Feldman SR, Teuschler HV, Fleischer AB, Jr., Goldman ND, et al. Nonmelanoma skin cancer: an episode of care management approach. Dermatol Surg, 2003; 29(7): 700-11.
Askari SK, Schram SE, Wenner RA, Bowers S, Liu A, Bangerter AK, et al. Evaluation of prospectively collected presenting signs/symptoms of biopsy-proven melanoma, basal cell carcinoma, squamous cell carcinoma, and seborrheic keratosis in an elderly male population. J Am Acad Dermatol, 2007; 56(5): 739-47.
Geller AC, Annas GD. Epidemiology of melanoma and nonmelanoma skin cancer. Semin Oncol Nurs, 2003; 19(1): 2-11.
Stang A, Ziegler S, Buchner U, Ziegler B, Jockel KH, Ziegler V. Malignant melanoma and nonmelanoma skin cancers in Northrhine-Westphalia, Germany: a patient- vs. diagnosis-based incidence approach. Int J Dermatol, 2007; 46(6): 564-70.
Tovar J, Carrasquilla H. Remisiones de médicos generales a dermatólogos. Revista Asociación Colombiana de Dermatología y Cirugía Dermatológica, 2005; 13(2): 116-119.
CEMIYÁ, Universidad del Valle, Secretaría de Salud Pública Municipal. Caracterización de la morbilidad materna extrema. Enero - Diciembre de 2005. Santiago de Cali: CEMIYÁ; Mayo de 2006.
Maine D, Akalin M, Ward V, Kamara A. Diseño y evaluación de programas para mortalidad materna. New York: Centro para la Población y Salud Familiar. Facultad de Salud Pública. Universidad de Columbia; 1997.
Gallego L, Gómez J, Escobar A. Modelos para el análisis de la mortalidad materna y perinatal. Primera ed. Medellín: Alcaldía de Medellín. Secretaría de Salud; 2005.
Baumert J, Plewig G, Volkenandt M, Schmid-Wendtner MH. Factors associated with a high tumour thickness in patients with melanoma. Br J Dermatol, 2007; 156(5): 938-44.
Carli P, De Giorgi V, Palli D, Maurichi A, Mulas P, Orlandi C, et al. Dermatologist detection and skin self-examination are associated with thinner melanomas: results from a survey of the Italian Multidisciplinary Group on Melanoma. Arch Dermatol, 2003; 139(5): 607-12.
Carli P, De Giorgi V, Giannotti B, Seidenari S, Pellacani G, Peris K, et al. Skin cancer day in Italy: method of referral to open access clinics and tumor prevalence in the examined population. Eur J Dermatol, 2003; 13(1): 76-9.
Brochez L, Verhaeghe E, Bleyen L, Naeyaert JM. Time delays and related factors in the diagnosis of cutaneous melanoma. Eur J Cancer, 2001; 37(7): 843-8.
Hennrikus D, Girgis A, Redman S, Sanson-Fisher RW. A community study of delay in presenting with signs of melanoma to medical practitioners. Arch Dermatol, 1991; 127(3): 356-61.
Kirsner RS, Wilkinson JD, Ma F, Pacheco H, Federman DG. The association of Medicare health care delivery systems with stage at diagnosis and survival for patients with melanoma. Arch Dermatol, 2005; 141(6): 753-7.
Lydiatt DD. Medical malpractice and cancer of the skin. Am J Surg, 2004; 187(6): 688-94.
Rhodes AR. Public education and cancer of the skin. What do people need to know about melanoma and nonmelanoma skin cancer? Cancer, 1995; 75(2 Suppl): 613-36.
Schmid-Wendtner MH, Baumert J, Stange J, Volkenandt M. Delay in the diagnosis of cutaneous melanoma: an analysis of 233 patients. Melanoma Res, 2002; 12(4): 389-94.
Swetter SM, Soon S, Harrington CR, Chen SC. Effect of health care delivery models on melanoma thickness and stage in a university-based referral center: an observational pilot study. Arch Dermatol, 2007; 143(1): 30-6.
Youl PH, Baade PD, Janda M, Del Mar CB, Whiteman DC, Aitken JF. Diagnosing skin cancer in primary care: how do mainstream general practitioners compare with primary care skin cancer clinic doctors? Med J Aust, 2007; 187(4): 215-20.
Temoshok L, DiClemente RJ, Sweet DM, Blois MS, Sagebiel RW. Factors related to patient delay in seeking medical attention for cutaneous malignant melanoma. Cancer, 1984; 54(12): 3048-53.
Rampen FH, Rumke P, Hart AA. Patients and doctors delay in the diagnosis and treatment of cutaneous melanoma. Eur J Surg Oncol, 1989; 15(2): 143-8.
Krige JE, Isaacs S, Hudson DA, King HS, Strover RM, Johnson CA. Delay in the diagnosis of cutaneous malignant melanoma. A prospective study in 250 patients. Cancer, 1991; 68(9): 2064-8.
Richard MA, Grob JJ, Avril MF, Delaunay M, Gouvernet J, Wolkenstein P, et al. Delays in diagnosis and melanoma prognosis (II): the role of doctors. Int J Cancer, 2000; 89(3): 280-5.
Richard MA, Grob JJ, Avril MF, Delaunay M, Gouvernet J, Wolkenstein P, et al. Delays in diagnosis and melanoma prognosis (I): the role of patients. Int J Cancer, 2000; 89(3): 271-9.
Silfen R, Amir A, Regev D, Hauben DJ. Role of physicians and patients in the diagnostic delay of cutaneous malignant melanoma. Ann Plast Surg, 2002; 49(4): 439-42.
Youl PH, Raasch BA, Janda M, Aitken JF. The effect of an educational programme to improve the skills of general practitioners in diagnosing melanocytic/pigmented lesions. Clin Exp Dermatol, 2007; 32(4): 365-70.
