Abstract
Introduction: Most cancer disparities research has traditionally focused on two key outcomes, access
to appropriate treatment and survival, but they do not encompass important aspects
of patient-centered care such as the timeliness of diagnosis and treatment. Prolonged
time intervals between symptom onset and treatment initiation increase the risk of
poorer clinical outcomes and are associated with worse patient experience of subsequent
cancer care. This study aims to assess the delay from symptom onset to the start of
definitive treatment and to identify the possible contributory factors and its impact
on response in cancers of head and neck, breast, cervix, and lung. Materials and Methods: This was a retrospective study of patients enrolled between 2015 and 2017. A questionnaire
was filled in about socioeconomic aspects, patient history, tumor data, professionals
who evaluated the patients, and the respective time delays. Statistical test included
Mann–Whitney U test, univariate and multivariate test, and one-way ANOVA to evaluate
the correlations. Results: Stage migration was significant with patient delay (P < 0.01). In head and neck squamous cell carcinoma (HNSCC) and Carcinoma lung, a significant
correlation was found between referral delay and residence (P < 0.01) and treatment delay and reason for referral (HNSCC only) (P = 0.04). Referral delay and treatment delay were correlated to response in breast
and cervix, respectively (P < 0.01). Conclusion: Social awareness, regularly updating primary care physicians about alarming symptoms
of cancer, developing guidelines to identify these symptoms, promoting continuity
of care, and enabling access to specialist expertise through prompt referral should
all help prevent delays in cancer diagnosis.
Key words
Barrier - diagnostic delay - four cancers - health care - impact
