Original articleDetection and Time to Treatment of Uveal Melanoma in the United Kingdom: An Evaluation of 2384 Patients
Section snippets
Inclusion Criteria
Patients were included in this study if (1) they were diagnosed with uveal melanoma at the Liverpool Ocular Oncology Center between 1997 and 2011; (2) their referral was initiated by a family doctor, optometrist, or ophthalmologist; and (3) they resided in the United Kingdom. There were approximately 21 patients (0.1%) whose referral was initiated by other practitioners, such as radiologists, nurses, and gynecologists. These outliers were excluded to enhance the clarity and brevity of this
Patient Demographics
A review of our database showed that 2384 patients were referred to our unit between April 1997 and March 2011 (Table 1, available at http://aaojournal.org). The patients (1175 female, 1209 male) had a median age of 62.1 years when their tumor was detected or the referral process was initiated. The first practitioner in this care pathway was an optometrist in 1621 patients (68.0%), a family doctor in 435 patients (18.2%), and an ophthalmologist in 328 patients (13.8%) (Fig 1). Before 2001, the
Main Findings
The time from initiation of the referral process to the date of primary ocular treatment exceeded 6 months in 19.8% of patients. This delay was considerably longer in patients who reported that their tumor had been missed (median, 92 vs. 40 days). Such patients accounted for 23.1% of our cohort. Patients initially seen by an optometrist waited longer to see an ophthalmologist if they were referred via a family doctor instead of directly (median, 44 vs. 10 days). Conversely, patients whose
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Manuscript no. 2011-1606.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
The Liverpool Ocular Oncology Center is funded by the National Specialist Commissioning Team of the National Health Service of England, which had no role in the design or conduct of this study.