Patient Delay Seen as Problem in Cancer Treatment in India

Patient Delay Seen as Problem in Cancer Treatment in India

People in India often wait months before seeking medical help for a suspected cancer, a delay that often impacts their treatment and outcomes, a study of cancer patients in that country found.

The study, “Diagnostic delay in oncology: Is there a need for increasing cancer awareness among primary care physicians of developing countries?,” is being presented in a poster session at the European Society for Medical Oncology Congress in Asia (ESMO Asia Congress 2016), taking place Dec. 16–18, in Singapore.  The research shows that, on average, patients wait four months before seeking a cancer diagnosis, and the delays impacted the nature of the treatment they received.

“Patients with longer delays before diagnosis were more likely to receive palliative, rather than curative, treatment because they had advanced disease — and are likely to have poorer outcomes,” Raviteja Miriyala, the study’s lead author and a senior resident at the department of radiotherapy and oncology at the Postgraduate Institute of Medical Education and Research in India, said in a press release.

Researchers analyzed the factors contributing to a delayed diagnosis and initiation of cancer treatment in developing countries, and evaluated the influence of such delay on treatment intent.

This prospective audit included 162 cancer patients referred to the researcher’s department by primary care physicians in January 2015. The team then gathered details regarding when cancer-related symptoms were first noticed by the patient, and the date of first consultation with a primary physician and with an oncologist. When a cancer therapy was started and its intent (curative or palliative) were also noted.

Researchers used the data collected to calculate three time intervals: how long it took for a patient to seek primary care (patient delay), the time interval between the primary care physician and a first meeting with an oncologist (physician delay), and the time until the start of on treatment (oncologist delay).

On average, about six months passed between first symptoms and start of cancer treatment, a delay largely due to patient hesitation in requesting medical attention (four-month delay, on average) and slow primary care physician referrals (three weeks). Oncologists were seen to start care with an average delay of 10 days.

Shorter delays were observed for brain and lung cancers, and longer delays for head and neck cancers. Significant correlations were observed between patient delay and education status, physician delay and rural setting, and oncologist delay and cancer site.

“This study highlights the perils of diagnostic delays and how they can lead to changes in treatment intent and presumably ultimately affect cancer outcomes. It is important to educate the general public to recognize suspicious symptoms which demand medical help, and to go for screening tests such as those that identify breast, colon and cervical cancers before symptoms develop,” said Sing-Huang Tan, senior consultant at Singapore’s National University Cancer Institute.

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