Factors of cancer diagnosed family and medical system for delay in diagnosis and treatment of esophageal cancer

Abstract

Introduction. The esophagus cancer patients needs early diagnosis to achieve better prognosis. The delay barriers increase progression of diseases to higher stages. The aim of work was to identify and explore the barriers in diagnosis of esophagus cancer and chart the time duration in this process. Material and Methods. The study was conducted in Jinnah Hospital Lahore (JHL), a teaching care hospital of Allama Iqbal Medical College, during a period of one year from July 2019 to July 2020. There were 49.42 % female and 50.57 % male patients. Results. Mean age found to be 56 years. Mean Total delay (TD ) time was 206 days and median Total delay (TD ) time in days were 197 days with 25th and 75th (157, 246) percentiles respectively. Longest delays were found in 51–60 age group and age related (r=0.94) significantly to delays (p=0.0004). Initial symptom of weight loss shows maximum delay and symptoms are highly correlated (r=0.94) with delay (p=0.004). The low income group presents maximum delay. Mean patient delay (PD ) time in days were 142 days with 135 Median and (88, 195) 25th and 75th percentile respectively. Mean, Median, 25th and 75th percentiles for Physician delays (PhyD) times were (20, 18, 16, 23) respectively. Treatment delay (TD ) time (Mean, Median) in days were (18, 18.52) with 25th and 75th (14, 22) percentiles. The education significantly reduces the delays with correlation (r=0.91) and significance (p=0.02). Mean system delay (SD ) time were 25 days and median were 24 days with 25th and 75th (20, 31) percentiles. Conclusion. Illiteracy, financial problems, and unavailability of information related to the cancer and health care system, very limited number of health facilities remains the main causes of these delays.

Keywords

• esophageal cancer
• late diagnosis
• cancer alertness