title: Treatment delay of bone tumours, compilation of a sociodemographic risk profile: a retrospective study.
abstract: BACKGROUND
  Bone tumours are comparatively rare tumours and delays in diagnosis and treatment are common. The purpose of this study was to analyse sociodemographic risk factors for bone tumour patients in order to identify those at risk of prolonged patients delay (time span from first symptoms to consultation), professional delay (from consultation to treatment) or symptom interval (from first symptoms to treatment). Understanding these relationships might enable us to shorten time to diagnosis and therapy.
  
  
  METHODS
  We carried out a retrospective analysis of 265 patients with bone tumours documenting sociodemographic factors, patient delay, professional delay and symptom interval. A multivariate explorative Cox model was performed for each delay.
  
  
  RESULTS
  Female gender was associated with a prolonged patient delay. Age under 30 years and rural living predisposes to a prolonged professional delay and symptom interval.
  
  
  CONCLUSIONS
  Early diagnosis and prompt treatment are required for successful management of most bone tumour patients. We succeeded in identifying the histology independent risk factors of age under 30 years and rural habitation for treatment delay in bone tumour patients. Knowing about the existence of these risk groups age under 30 years and female gender could help the physician to diagnose bone tumours earlier. The causes for the treatment delays of patients living in a rural area have to be investigated further. If the delay initiates in the lower education of rural general physicians, further training about bone tumours might advance early detection. Hence the outcome of patients with bone tumours could be improved.
authors.affiliation: Department of Orthopedic Surgery, University of Cologne, Joseph-Stelzmann-Str,9, 50924 Cologne, Germany. christophschnurr@gmx.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Schnurr
authors.forename: Mathias
authors.initials: M
authors.lastname: Pippan
authors.forename: Hartmut
authors.initials: H
authors.lastname: Stuetzer
authors.forename: Karl S
authors.initials: KS
authors.lastname: Delank
authors.forename: Joern W P
authors.initials: JW
authors.lastname: Michael
authors.forename: Peer
authors.initials: P
authors.lastname: Eysel
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D016896:Treatment Outcome