Identifying the Factors Causing Delayed Presentation of Cancer Patients to a Government Medical College of Central India (original) (raw)
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An epidemiological study on delay in treatment initiation of cancer patients
Scientific Research Publishing
Early diagnosis and timely initiation of treatment of cancer patients may improve survival and quality of life. Various measures of delay can be made during diagnosis and treatment initiation. Most of the studies were based on single type of cancer with different definitions and measurements of delay in diagnosis and treatment. Thus, it has been difficult to synthesize results and generalize to other types of cancer. The study proposes to measure total duration between onsets of symptom to start of treatment into three components, namely primary, secondary and tertiary delays. Primary delay is defined as onset of symptoms to contacting the first medical person, secondary delay is from first medical contact to confirmed diagnosis, and tertiary delay is from confirmed diagnosis to treatment initiation. The aim of this study is to determine factors associated with primary, secondary and tertiary delays in cancer patients. This study was planned as a cross-sectional study. Data was collected from patients admitted to the surgical wards of Department of Surgical Oncology, Institute Rotary Cancer Hospital, New Delhi during 2006-2007. Gamma regression and quantile regressions at 25th, 50th and 75th percentile of each of the delays were used to determine related factors. A total of 403 patients were included in the analysis. The median tertiary delay was found almost two folds (59; Interquartile range: 26 - 101 days) than the primary and secondary delays. Extremity cancer patients had longest primary, secondary and tertiary delays. Shortest primary, secondary and tertiary delays were observed for gastrointestinal cancer, breast and genitourinary cancer respectively. There is an urgent need and scope to reduce delay at each level primary, secondary and tertiary delay. Intervention studies are needed through information, education and communication/screening programs to reduce the diagnostic and treatment delays in cancer patients.
Identification of factors influencing delayed presentation of cancer patients
International Journal Of Community Medicine And Public Health
Background: Delayed presentation of patients of cancer is associated with poorer survival. Early presentation, timely diagnosis and treatment are critical factors in improving long-term survival for patients with cancer. Thus, reducing delays in diagnosis of cancer should be a priority. Against this backdrop this study was conducted to identify factors leading to delayed presentation of patients in advanced stages of cancer at our institute. Methods: Newly diagnosed patients of cancer coming to radiation oncology, surgery and medical oncology outpatient departments were included in this study. Data was collected in a pre-validated questionnaire format.Results: 360 patients were included. Majority of patients 212 (58.9%) were male. 66.7% patients were from rural areas. Most of the patient’s educational level was upto primary schooling 178 (49.4%) and caregiver educational level was upto primary schooling 153 (42.5%). Reason for alternative treatment correlated significantly with pat...
Factors Associated with Delay in Treatment of Cancer
National Journal of Community Medicine
Introduction: This is a cross sectional study conducted on cancer patients who presented at the peripheral cancer center, Mandya Institute of Medical Sciences, Mandya with an objective to find out the possible factors influencing the delay in treatment of cancer. Method: Each day the patients coming for radiotherapy treatment were selected, based on the inclusion criteria for the study and an informed consent was taken before collecting the data. Data was collected by questionnaire method and was entered in an excel sheet and analyzed. Result: The result revealed that 65% of the patients belonged to the age group 50-69 and that the delay in treatment significantly increased with increase in age, 80% of the patients were not aware and their median delay was about 60 days, 59% of the patients neglected the symptoms and their median delay was about 60 days, and 5 percent of them took self-treatment and their median delay was 60 days. Conclusion: This study, revealed that 4 important fa...
Patient delay in cancer studies: a discussion of methods and measures
BMC Health Services Research, 2009
Background: There is no validated way of measuring the prevalence and duration of patient delay, and we do not know how people perceive and define the time intervals they are asked to report in patient delay studies. This lack of a validated measure hampers research in patient delay and is counterproductive to efforts directed at securing early diagnosis of cancer.
Predictors of patient delay among upper aerodigestive tract cancer patients in Morocco
Annals of Cancer Research and Therapy
Introduction: Reducing "patient delay" in upper aerodigestive tract cancer (UADTC) is critical to improving patient prognosis and quality of life. The objective of this study was to assess "patient delay" and identify the association between this delay and other factors such as socioeconomic , clinical, and traditional medicine use. Methods: A cross-sectional study was conducted at Sidi Mohammed Ben Abdellah National Institute of Oncology in Rabat, Morocco. A consecutive series of patients with UADTC were selected. "patient delay" was calculated using the date of the patients' awareness of the symptoms and the date of the first medical consultation. A multivariate binary logistic regression analysis was performed to measure the association between other different factors and "patient delay". Results: 201 patients were selected for this study. 65.7% of the patients were male, 79.4% were diagnosed with stage III or IV, the median of the patient's delay was 120 days, 57.7% of them had a long "patient delay". In addition, 60.2% of patients used traditional medicine, of which 57.0% had already used it before the first consultation. Multivariate analysis revealed that the use of traditional medicine for more than 15 days (p = 0.017) was a risk factor for "patient delay", whereas medium or high socioeconomic status (p = 0.045) and malignant interpretation of the patient's symptoms (p = 0.008) were protective factors. Conclusion: Our results will help to understand the individual and collective factors that may explain the issue of "patient delay", which is a critical parameter in the early diagnosis and prevention of mortality from UADTC.
National Journal of Community Medicine, 2013
Purpose: Tuberculosis in India accounts for 1/3rd of global burden. Initiation of treatment by the health system is an essential step. The aim of this study was to assess delay in the treatment in AMC area. Methodology: All smear positive patients who had treatment delay were identified from 10TUs of AMC who had started treatment between 1stOctober 2010 and 30thSeptember 2011. Out of total 204, 14 had migrated and 30 had initiated treatment during hospitalization soon after diagnosis were excluded. Therefore, 160 patients were interviewed in DOTS centre or in their homes using predesigned and pretested questionnaire. Results: Mean age was 37.3+14.6 years and 69(43.1%) were in the 26 to 45 age group. About 114(71%) were male. Category I, II and IV Tuberculosis patients were 38.7%, 61.2%, and 0.06% respectively. The median duration for treatment delay was 14 days (range 8 to 90). Factors responsible for delayed initiation of treatment included health system delay (36.8%), personal reasons (92.5%) and both (28.7%). Important factors of treatment delay were social (34%) followed by adverse effects of drugs (32%) and referral delay from another TU (29%). After adjusting various factors like gender (female) and lower socio-economic class, personal reasons emerged as significant determinants for treatment delay more than 14 days. Conclusion: Present As demonstrated in this study, significant factors were lower socio-economic class, personal reasons and female sex, these factors must be taken into account while giving health education. Sound referral system can also minimize treatment delay.
Treatment delay of cancer patients in Indonesia: a reflection from a national referral hospital
Medical Journal of Indonesia, 2021
BACKGROUND Cancer is a complex disease requiring a multidisciplinary approach in establishing prompt diagnosis and treatment. Treatment in a timely manner is crucial for the outcomes. Hence, this study aimed to provide information on treatment delay including patient and provider delays and its associated factors. METHODS Cancer patients were recruited conveniently in the outpatient clinic of Department of Radiation Oncology, Cipto Mangunkusumo Hospital, Indonesia between May and August 2015. All patients were asked to fill a questionnaire and interviewed in this cross-sectional study. Treatment delay was explored and categorized into patient delay and provider delay. Patient delay could be happened before (patient-delay-1) or after (patient-delay-2) the patient was diagnosed with cancer. Provider delay could be due to physician, system-diagnosis, and system-treatment delays. RESULTS Among 294 patients, 86% patient had treatment delay. Patient delay was observed in 153 patients, and...
Determinants of patient delay in doctor consultation in head and neck cancers (Protocol DEREDIA)
BMJ Open, 2014
Introduction: Reducing the time between the onset of the first symptoms of cancer and the first consultation with a doctor (patient delay) is essential to improve the vital prognosis and quality of life of patients. Longer patient delay is linked to the already known sociodemographic, socioeconomic, socioeducational, sociocultural and socioprofessional factors. However, recent data suggest that some sociocognitive and emotional determinants may explain patient delay from a complementary point of view. The main objective of this study is to assess whether, in head and neck cancer, patient delay is linked to these sociocognitive and emotional factors, in addition to previously known factors. Methods and analysis: We intend to include in this study 400 patients with a not yet treated head and neck cancer diagnosed in one of six health centres in the North of France region. The main evaluation criterion is 'patient delay'. Sociocognitive, emotional, medical, sociodemographic, socioeconomic, educational, professional and geographic factors will be assessed by means of (1) a case report form, (2) a questionnaire completed by the clinical research associate together with the patient, (3) a questionnaire completed by the patient and (4) a recorded semidirective interview of the patient by a psychologist (for 80 patients only). The collected data will be analysed to underline the differences between patients who consulted a doctor earlier versus those who consulted later. Ethics: The study has obtained all the relevant authorisations for the protection of patients enrolled in clinical trials (CCTIRS, CCP, CNIL), does not involve products mentioned in article L.5311-1 of the French Code of Public Health, and does not imply any changes in the medical care received by the patients. The study began in October 2012 and will end in June 2015.
2021
Introduction: Cancer treatment and prognosis depend heavily on early detection. Survival in the early stages is excellent for almost all types of cancer. Unfortunately, in Saudi Arabia, a large number of cancer patients present with advanced disease, resulting in a poor prognosis. There are three levels of delay in the management of cancer patients. The fi rst level is the time between the fi rst cancer-related symptoms and the presentation to the health facility, the second level is from the presentation to the diagnosis, and the third level is between the diagnosis and the treatment. This study aims to determine if there is a delay, at what level and to study the factors causing such delays. Materials and methods: Two hundred cancer patients who presented to the Armed Forces Hospital Southern Region, Oncology Department, were interviewed from January 1 st to June 30 th , 2018. The interviews were conducted by trained physicians familiar with the questionnaire's contents. The questionnaire consisted of four sections: a demographic section and three more sections to identify factors causing the delay at the three levels from the patients' perspectives. All data were analyzed using the SPSS version 20.0. Results: The mean patient age was 63 years. A total of 112 patients were female and 88 were male. The most common cancer type was breast cancer (27.5%). Among the patients, 61% were illiterate and 25.5% had elementary school degrees, 86% expressed little or no general medical knowledge about cancer. More women than men paid attention to cancer symptoms (70% vs. 54%). 75% of the patients presented to the fi rst health facility after 2 months from the fi rst appearance of symptoms (level 1 delay). Only 2% of the patients presented within one week. 50% of the patients received a diagnosis after visiting two health facilities. All patients were diagnosed at hospitals. 40% of patients used alternative medicines, 70% of whom thought this was the cause of their delayed presentations. 67% had their diagnosis confi rmed within one month (level 2 delay), and 66% started their defi nitive treatment within one month (level 3 delay). 75% of the patients blame themselves for the delay. Educational level (p = 0.03), knowledge about cancer (p < 0.01), and the use of complementary and alternative medicines (CAM) (p = 0.01) were signifi cantly associated with delayed presentation of patients to the health facility. Conclusion: There is a delay in the presentation of cancer patients (level 1) in the southern part of Saudi Arabia. Educational level, knowledge of cancer symptoms, and use of complementary and alternative medicines are the main causes. There were no delays in diagnosis and start of treatment (level 2,3).