FACTORES RELACIONADOS CON LA CONSULTA TARDÍA A DERMATOLOGÍA POR CÁNCER DE PIEL: PRUEBA PILOTO. DEPARTAMENTO DE CALDAS

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Abstract

Introducción: investigaciones realizadas por la Universidad de Caldas, ponen de manifiesto la tendencia a consultar tardíamente por cáncer de piel al especialista. Objetivo: identificar en el departamento de Caldas los factores por los cuales los pacientes con cáncer de piel consultan de manera tardía a dermatología. Materiales y métodos: estudio descriptivo retrospectivo en 62 pacientes con cáncer de piel, atendidos en la Universidad de Caldas desde enero de 2005 hasta junio de 2007. Se estudiaron las características demográficas, socioeconómicas y actitudinales de los pacientes, los factores asociados con el sistema de salud y con la lesión cutánea. Los resultados se describieron utilizando promedio, desviación estándar, valores mínimo y máximo, percentiles y frecuencias relativas. Se buscó diferencia entre los retrasos según las características de los pacientes con la prueba chi2. Se aceptó como significativa un p<0,05. El análisis estadístico se realizó con el software SPSS 15.0. Resultados: se identificó al paciente como el principal factor de retraso para consultar. Sobresalieron en ellos: sexo femenino, edad superior a 60 años, baja escolaridad y régimen subsidiado. La mayor parte de ellos refirió no haber recibido información previa sobre el tema. Conclusión: si bien hay aspectos por mejorar en los distintos niveles de atención en salud, el factor preponderante que podría explicar la consulta tardía por cáncer de piel a dermatología se relacionó con las características y actitudes de los pacientes.

Translated 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.

Translated abstract

Introdução: pesquisas realizadas pela Universidade de Caldas põem de manifesto a tendência a consultar tardiamente por o câncer de pele ao especialista. Objetivo: Identificar no Estado de Caldas os fatores por os quais os pacientes com câncer de pele consultam de maneira tardia a dermatologia. Materiais e métodos: a pesquisa retrospectiva em 62 pacientes com câncer de pele, atendidos na Universidade de Caldas desde janeiro de 2005 ate junho de 2007. Estudaram se as características demográficas, socioeconômicas e atitudinais dos pacientes, os fatores associados com o sistema de saúde e com a lesão cutânea. Os resultados descreveram se utilizando a média, desviarão standard, valores mínimo e maximo, percentiis e freqüências relativas. Pesquisou-se diferencia entre os retraços conforme as características dos pacientes com a amostra chi2. Aceitou-se como significativa um p<0,05. A análise estadística se realizou com o software SPSS 15.0. Resultados: se identificou ao paciente como o principal fator de retraso para consultar. Destaca-se em eles: sexo feminino, idade superior a 60 anos, baixa escolaridade e regime subsidiado. A maior parte de eles referiu Não haver recebido informação previa sobre o tema. Conclusão: Si bem há aspetos por melhorar nos distintos neveis de atenção em saúde, o fator preponderante que poderia explicar a consulta tardia por câncer de pele a dermatologia se relacionou com as características e atitudes dos pacientes.

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Public education and cancer of the skin. What do people need to know about melanoma and nonmelanoma skin cancer?

Katherine A. Rhodes (1995)

Cutaneous melanoma (CM) and nonmelanoma skin cancer (NMSC) have a high chance for cure if detected in an early phase of development. Patients who have these tumors may now be treated in the outpatient setting with a minimum of discomfort, inconvenience, and cost. Most skin cancer deaths are caused by CM. Until recently, CM incidence in the United States has been increasing faster than any other potentially lethal cancer, attributable at least in part to aggressive case detection and greater public awareness about the significance of risk factors and early warning signs of evolving tumors, resulting in increased numbers of curable tumors. Most CMs are discovered by patients or close acquaintances. Most CM deaths are related to patient delay in seeking medical care. Patient delay is attributed mostly to lack of knowledge rather than to fear and denial. In the United States, primary prevention of CM and NMSC has focused on encouraging sensible sun-exposure behaviors, while secondary prevention consists of a yearly national campaign that promotes skin awareness and self-examination and free examinations to detect evolving tumors, sponsored by the American Academy of Dermatology and the American Cancer Society. More attention is needed to encourage timely consultation for evolving tumors and predisposing risk factors and to focus screening and surveillance efforts of those people at greatest risk. Public education must continue to promote personal responsibility in the intervention process to reduce the morbidity and mortality associated with CM and NMSC.