Identification of factors influencing delayed presentation of cancer patients (original) (raw)
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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...
Cancer Management and Research
Background: Delay in seeking health care by breast cancer patients is associated with advanced stage of disease at presentation and poor survival rates. This study aimed to identify the reasons for delayed presentation and their association with various sociodemographic variables. Methods: A total of 200 female patients with abnormal clinical findings, ie, lump or palpable mass, were consecutively invited for this study. Diagnostic delay was defined as a consultation with a health care provider more than 3 months from the appearance of the first symptoms. Sociodemographic variables, presenting symptoms, knowledge about diseases and its symptoms, time between seeking medical attention after appearance of symptoms and causes of delayed presentation were investigated. Chi-squared and logistic regression tests for significance and associations were used. Results: Among 125 women with breast cancer fulfilling the inclusion criteria, aged 24-75 years, 88.8% (n=111) presented late (≥3 months) and 59% presented with advanced stage of disease (stage III/IV). The majority (65.6%) were older than 40 years of age, 99.2% were married, 60.8% had <8 years of education, 67.2% had poor social status, and 64.8% had a negative family history of any cancer type. Almost all patients (96%) complained about the presence of a painless lump in their breast. Ignorance of disease or the presence of painless lumps in the breast and low financial resources for therapy (81.1%) were the main variables associated with delayed presentation. Educational factors (P<0.001, OR 4.682) and social status (P<0.001, OR 1.8) were also associated with delayed presentation. Conclusion: Our study highlighted the variables associated with delayed presentation in Pakistani breast cancer patients. A significant number of patients presented late owing to misconceptions and poor knowledge about the disease and its symptoms, while illiteracy and poor social status were the major contributing factors for delayed presentation, resulting in an advanced presentation of disease and ultimately a decreased survival rate.
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.
British journal of cancer, 2009
It has been suggested that the known poorer survival from cancer in the United Kingdom, compared with other European countries, can be attributed to more advanced cancer stage at presentation. There is, therefore, a need to understand the diagnostic process, and to ascertain the risk factors for increased time to presentation. We report the results from two worldwide systematic reviews of the literature on patient-mediated and practitioner-mediated delays, identifying the factors that may influence these. Across cancer sites, non-recognition of symptom seriousness is the main patient-mediated factor resulting in increased time to presentation. There is strong evidence of an association between older age and patient delay for breast cancer, between lower socio-economic status and delay for upper gastrointestinal and urological cancers and between lower education level and delay for breast and colorectal cancers. Fear of cancer is a contributor to delayed presentation, while sanctioni...
Chinese journal of cancer research = Chung-kuo yen cheng yen chiu, 2015
There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. The objectives were to determine the frequency of breast cancer patients with delayed presentation, the reasons of delay and its association with different socio-demographic variables in our settings. We interviewed 315 histologically confirmed breast cancer patients. Delay was defined as more than 3 months from appearance of symptoms to the consultation from doctor. Questions were asked from each patient which could reflect their understanding about the disease and which could be the likely reasons for their delayed presentation. A total of 39.01% (n=123) of patients presented late and out of those, 40.7% wasted time using alternative medicines; 25.2% were not having enough resources; 17.1% presented late due to painless lump; 10.6% felt shyness and 6.5% presented late due to other reasons. Higher age, negative family history, <8 school years of education and low to middle socio-ec...
International Journal of Medical and Biomedical Studies, 2019
Background: Delay in presentation of breast cancer is usually detrimental to patient survival. Women with breast from rural areas of developing countries usually present late because of shyness and unawareness about the grave nature of disease. Under this background present study was carried out. Materials and Methods: This prospective study was conducted over a period of 4 years in the Department of Surgery in SMHS (Shri Maharaja Hari Singh) hospital at Government Medical College Srinagar, Jammu and Kashmir, India, from January 2013 to January 2017. A total of 31 patients of advanced breast cancer with delayed presentation were studied during this period. Objective: Our aim wasto look for the reasons of delayed presentation of breast carcinoma and highlight the need for measures to be taken in this regard. Results: The age of the patients ranged from 33 years to 77 years. The mean age was 61.9 years. The average age in the elder group (>50 years) was 68 years. Most of the patie...
Presentation Delay in Breast Cancer Patients, Identifying the Barriers in North Pakistan
Asian Pacific Journal of Cancer Prevention, 2015
Background: There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. Our objectives were to determine the frequency of breast cancer patients with delayed presentation, the reasons of delay and its association with different socio-demographic variables in our North Pakistan setting. Materials and Methods: We interviewed 315 histologically confirmed breast cancer patients. Delay was defined as more than 3 months from appearance of symptoms to consultation with a doctor. Questions were asked from each patient which could reflect their understanding about the disease and which could be the likely reasons for their delayed presentation. Results: 39.0 % (n=123) of patients presented late and out of those, 40.7% wasted time using alternative medicines; 25.2 % did not having enough resources; 17.1 % presented late due to painless lump; 10.6% felt shyness and 6.5% presented late due to other reasons. Higher age, negative family history, < 8 school years of education and low to middle socioeconomic status were significantly associated with delayed presentation (p< 0.05). Education and socioeconomic status were two independent variables related to the delayed presentation after adjustment for others (OR of 2.26, 2.29 and 95%CI was 1.25-4.10, 1.06-4.94 respectively). Conclusions: Significant numbers of women with breast cancer in North Pakistan experience presentation delay due to their misconceptions about the disease. Coordinated efforts with public health departments are needed to educate the focused groups and removing the barriers identified in the study. Long term impact will be reduced overall burden of the disease in the region.
Factors Influencing Delayed Diagnosis in Oncology
Maedica, 2020
Background: In Romania there is a discrepancy between cancer incidence (last place in Europe) and mortality rate (over the medium rate in Europe), possibly due to a higher number of late diagnosis. This study aims to determine associations between delayed cancer diagnosis and psychosocial characteristics (depression, coping style, social support). Methods: Cancer patients were administered a battery of tests for depression, anxiety, coping mechanism, social support, social status, medical and family history, and time between first symptoms and diagnosis. Results: Delayed presentation was positively correlated with female gender (p=0.031), rural area (p=0.033) and law stress levels (p=0.045), depression (p=0.02). positive reassessment (p=0.002) and low positive refocusing (p=0.006). Conclusion: Coping styles, depression and gender influence delayed diagnosis of cancer, this potentially contributing to a bad prognosis of oncology patients. Further longitudinal studies and screening pr...