MARC 主機 00000nam  2200385   4500 
001    AAI3173190 
005    20080530093139.5 
008    080530s2005                        eng d 
020    9780542105234 
035    (UMI)AAI3173190 
040    UMI|cUMI 
100 1  Shieh, Shwn-Huey 
245 14 The influence of patient-dependent delay on staging and 
       survival in lung cancer in Taiwan 
300    144 p 
500    Source: Dissertation Abstracts International, Volume: 66-
       04, Section: B, page: 2020 
500    Major Professor: Janice C. Probst 
502    Thesis (Ph.D.)--University of South Carolina, 2005 
520    Delay at diagnosis is a harmful problem for the survival 
       of cancer patients. Patients with delayed diagnosis 
       develop occult metastases and have a more advanced stage 
       of disease at diagnosis. Little research has been done on 
       stage of disease at diagnosis and survival due to patient-
       dependent delay. This study investigates the covariates 
       associated with patient-dependent delay, analyzes the 
       relationship between patient-dependent delay and staging, 
       and assesses the survival time of patients with lung 
520    The study consists of 1,300 lung cancer patients from a 
       medical center hospital in central Taiwan from January 1, 
       1998 to March, 2003. Data was analyzed using the SAS 
       system to conduct Cox regression analysis 
520    The study finds that symptom recognition (chest pain (P = 
       0.0021), lost body weight (P = 0.0001), and department (P 
       = 0.0002)) is significantly associated with patient-
       dependent delay. Patients with symptom recognition (chest 
       pain, body weight loss) obtained medical consultations 
       more quickly than those who did not recognize chest pain 
       and body weight loss. Gender, marital status, patient TB 
       (Tuberculosis) history, patient DM (Diabetes Mellitus) 
       history and stage of disease were statistically 
       significant predictors of survival after controlling 
       simultaneously for all main variables. A more serious 
       stage of disease at diagnosis tended to be associated with
       a lower chance of survival. However, tumor stage at 
       diagnosis and survival did not appear to be significantly 
       influenced by patient-dependent delay. Health behaviors, 
       such as smoking, alcohol and betel-nut consumption, showed
       no effect on survival, as well as stage at diagnosis 
520    The findings may help policy makers to modify current 
       policies, focusing on preventive medicine in order to 
       develop lung cancer education programs aimed at alerting 
       the public to early warning signs and symptoms of lung 
       cancer and encourage a health care system focusing on 
       disease prevention and early detection 
590    School code: 0202 
590    DDC 
650  4 Health Sciences, Public Health 
650  4 Health Sciences, Health Care Management 
650  4 Health Sciences, Oncology 
690    0573 
690    0769 
690    0992 
710 20 University of South Carolina 
773 0  |tDissertation Abstracts International|g66-04B 
856 40 |u