Delay in the diagnosis of testicular tumours - changes over the past 18 years.
BACKGROUND
Delay in the diagnosis of testicular cancer is associated with greater morbidity and poorer prognosis. While the national agenda relates to reducing time to referral and diagnostic delay, delay in presentation has previously been recognised as a major cause of delay in the diagnosis of this patient group.


OBJECTIVE
To evaluate changes in referral times and patient awareness among men with testicular cancer in Yorkshire over the past 18 years.


METHODS
Prospective cohort study. Comparison was made with a similar study in Yorkshire in 1985.


METHODS
Leeds Cancer Centre Testicular Germ Cell Outpatient Clinic.


METHODS
Three hundred and thirty-one men, newly diagnosed with testicular cancer between August 1998 and October 2002, were asked to complete a questionnaire. The time taken from when the patient first noticed symptoms to their first visit to their general practitioner (GP), from their first GP visit to their first hospital visit, and from their first hospital visit to orchidectomy were recorded. We also asked patients about the treatment they were offered at their first GP visit.


RESULTS
Questionnaires were completed by 180 (54%) men. The median time that men took between when they first noticed symptoms and first visited their GP has decreased compared with 1985 (5 versus 2 weeks, respectively). No improvement was observed in referral times (mean = 3.55 versus 4.8 weeks). Ninety-one per cent of responders had heard of testicular cancer prior to diagnosis.


CONCLUSIONS
Patient performance has improved over the past 18 years. The data lends support to the effectiveness of national health education initiatives aimed at increasing public awareness and self-examination. GPs performed well in this study, assessing and referring men appropriately and urgently into secondary care.
Vasudev
Naveen S
NS
Germ Cell Tumour Clinic, Cookridge Hospital, Leeds.
Joffe
Johnathan K
JK
Cooke
Carolyn
C
Richards
Fiona
F
Jones
William G
WG
D000328:Adult; D001294:Attitude to Health; D015331:Cohort Studies; D004739:England; D005194:Family Practice / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D011446:Prospective Studies; D012017:Referral and Consultation; D016353:Self-Examination / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000523:psychology; D013997:Time Factors