Objective: To assess sources of delay in referral to a specialist Urology clinic for penile cancer.
Methods: Patients with penile cancer seen during the period December 2002 - December 2007 were identified from the unit’s database. Information regarding presentation, diagnosis, and pattern of referral was retrieved from records. Delay was defined as the time between the patient first noticing a penile lesion and date of first seeking medical advice, or additional time before being seen by a Urologist resulting from referral to another speciality.
Results: Of 100 patients, with a median age 54yrs (range 2-81yrs), 19% were initially referred to other specialities (Genitourinary Medicine – 13%, Dermatology – 4%, Plastics 2%). Initial referrals to GUM and Dermatology resulted in mean delays of 6 and 3.5 months respectively, whereas mean duration for patients to present to any medical practitioner from onset of symptoms was 5.8 months. Overall, 47% presented with locally advanced disease.
Conclusion: Approximately one fifth of patients with penile cancer are first referred to specialities other than Urology. This sometimes delays diagnosis, potentially affecting overall prognosis. The major source of delay, however, results from patient reluctance to seek medical advice. Thus, the greatest impact in this condition is likely to be achieved by increased public awareness and education.
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