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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1804891
Original Article

Investigating Diagnostic and Treatment Barriers in Cancer Care: A Rural Perspective from Western Maharashtra, India

Akash Nagar 
1   Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
,
Kavita Vishwakarma 
1   Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
,
Gayatri R. Nair 
1   Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
,
Akhil R. 
1   Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
,
Divya Madamanchi 
1   Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
› Author Affiliations Funding None.
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Abstract

Introduction Noncommunicable diseases, particularly cancer, are increasingly burdening India's health care system. Despite the implementation of various national cancer control programs, notable barriers to timely diagnosis and treatment persist, especially in rural regions.

Objectives This study aims to identify these barriers and assess diagnostic and treatment intervals among cancer patients in rural Western Maharashtra.

Materials and Methods A cross-sectional study was conducted at a tertiary cancer hospital from January to March 2024. Histopathologically confirmed patients with cancer (aged ≥ 18 years) who attended the radiotherapy and chemotherapy outpatient departments for treatment were included. Data was collected using structured interviews, focusing on sociodemographic factors, diagnostic intervals (from first symptom to final diagnosis), and treatment intervals (from final diagnosis to treatment initiation). Statistical analyses were performed using MedCalc software.

Results Out of 127 patients analyzed, the mean age was 53.4 years, with 68.5% being female. The majority resided in rural areas (52.0%). Breast cancer (26.8%), lip and oral cavity cancer (15.0%), and cervical cancer (10.2%) were the most prevalent among patients. The median total interval in diagnosis was 86 days, with a median diagnostic interval of 61 days and a median treatment interval of 8 days. Substantial barriers to timely diagnosis included misconceptions about symptom severity, neglect, and lack of knowledge about where to seek care. Rural residency and diagnosis of the first doctor consulted were significantly associated with longer diagnostic intervals.

Conclusion The study identified critical barriers to timely cancer diagnosis and treatment in rural Western Maharashtra, highlighting the need for increased awareness, better access to health care, and streamlined diagnostic processes. Addressing these challenges through targeted strategies can potentially reduce delays and improve cancer care outcomes, enhancing survival rates and quality of life for patients in this region. This study highlights the urgency for health care policymakers to prioritize and address these barriers to improve cancer care in rural India.

Keywords

barriers - cancer - diagnostic interval - noncommunicable diseases - treatment interval

Patient Consent

None.


Authors' Contributions

1. A.N.:

- Concept: Contributed to the initial idea and framework of the study.

- Design: Helped design the study methodology.

- Intellectual Content: Provided key insights and intellectual content throughout the study.

- Literature Search: Conducted a comprehensive literature review to support the study's background and rationale.

- Clinical Studies: Coordinated and supervised the data collection for the study.

- Data Analysis: Participated in the interpretation of the data.

- Statistical Analysis: Assisted in performing the statistical analysis.

- Manuscript Preparation: Contributed significantly to the writing of the manuscript.

- Manuscript Editing: Revised the manuscript for important intellectual content.

- Manuscript Review: Reviewed and approved the final manuscript before submission.

2. K.V.:

- Concept: Contributed to the development of the study concept.

- Design: Assisted in the design of the study methodology.

- Literature Search: Assisted with the literature review.

- Data Acquisition: Collected data from clinical sources.

- Data Analysis: Assisted in data interpretation.

- Statistical Analysis: Helped with statistical analysis.

- Manuscript Preparation: Assisted in writing the manuscript.

- Manuscript Editing: Helped with manuscript revisions.

- Manuscript Review: Reviewed the manuscript draft.

3. G.R.N.:

- Concept: Provided input on the study concept.

- Design: Assisted with study design.

- Intellectual Content: Contributed to the intellectual content of the study.

- Literature Search: Participated in the literature search.

- Clinical Studies: Involved in clinical data collection.

- Data Acquisition: Contributed to data collection efforts.

- Statistical Analysis: Participated in the statistical analysis.

- Manuscript Preparation: Contributed to drafting the manuscript.

- Manuscript Editing: Assisted with manuscript editing.

- Manuscript Review: Reviewed and provided feedback on the manuscript.

4. S.R.:

- Concept: Helped refine the study concept.

- Design: Contributed to the study design.

- Literature Search: Assisted in gathering relevant literature.

- Data Acquisition: Assisted in data acquisition.

- Data Analysis: Helped analyze the data.

- Manuscript Preparation: Contributed to manuscript writing.

- Manuscript Editing: Assisted with revisions.

- Manuscript Review: Reviewed the manuscript.

5. A.R.:

- Concept: Contributed to the conceptual framework.

- Design: Assisted in designing the study.

- Literature Search: Helped with the literature review.

- Data Acquisition: Participated in data collection.

- Data Analysis: Assisted in interpreting the data.

- Manuscript Preparation: Contributed to drafting sections of the manuscript.

- Manuscript Editing: Helped edit the manuscript.

- Manuscript Review: Reviewed the manuscript draft.

6. D.M.:

- Concept: Provided input on the initial concept.

- Design: Assisted in the study design.

- Literature Search: Participated in the literature search.

- Data Acquisition: Assisted in gathering data.

- Statistical Analysis: Contributed to the statistical analysis.

- Manuscript Preparation: Helped write the manuscript.

- Manuscript Editing: Assisted with editing the manuscript.

- Manuscript Review: Reviewed and approved the final draft.




Publication History

Article published online:
24 February 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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