Mode of presentation and time to treatment of XXXX in Finland.

@entity1 @entity1496 @entity5 @entity3739 @entity2184 @entity320
AIMS: To investigate the current referral pattern and delays in treatment of @entity1 with primary @entity2184 . METHODS: 184 consecutive Finnish @entity1 with @entity2184 diagnosed between July 1994 and June 1999 were eligible, and 159 were enrolled (inclusion rate, 86%). Their mean age was 60 years (range 14-87). The dates of visits to dispensing optician, physician, ophthalmologist and ocular oncologist, the presence of symptoms, and reason for consultation were determined by structured telephone interview. Time intervals to treatment planning and treatment were calculated. RESULTS: 139 @entity1 (87%) had symptoms at presentation and 44 @entity1 (28%) had been seen by an ophthalmologist less than 2 years previously. The median height of the @entity5 was 6 mm (range, 1.0-17.0) and its largest basal diameter 11 mm (range 2.5-22.0) at diagnosis. @entity320 developed from a previously detected presumed naevus in 13 @entity1 (8%). When the first contact was a dispensing optician (15%) the median time to treatment planning was 22 days (range 1-1156). When a physician other than an ophthalmologist (19%) was contacted the delay was 68 days (range 0-1283) and when an ophthalmologist (65%) was seen it was 34 days (range 1-1426). These differences were not significant (p=0.32). The chance of being referred at first visit was 89%. Median time to treatment was not associated with symptoms (p=0.16) and @entity5 volume (p=0.29), but it was significantly different between @entity1 who were and were not referred at first visit (140 days v 34 days; p<0.001) and between those treated by @entity3739 and @entity1496 brachytherapy (59 days v 33 days; p=0.009). CONCLUSIONS: Analysis of delays in management indicates that earlier treatment could be achieved if dilated fundus examinations were performed without exceptions, all suspicious naevi were referred for a second opinion, and if the @entity1 with @entity320 were referred to the ocular oncology service concurrently with staging examinations done at the regional hospital.
