Delay in Diagnosis Amongst Carcinoma Lung Patients Presenting at a Tertiary Respiratory Centre, India
Clinical Cancer Investigation Journal, Vol. 3, No. 4, July-August 2014
5 Pages Posted: 6 Jul 2014
Date Written: July 5, 2014
Objective: To determine time delay from the onset of initial symptoms to diagnosis of primary lung cancer.
Materials and Methods: Selected information was captured from 49 consecutive pathologically proven cancer lung patients presenting to a tertiary respiratory centre during 1st January to 30th June 2012 using semi‑structured interview schedule. All patients underwent suitable protocol based diagnostic work‑up and referral.
Results: Background profile of patient was as follows: Male:Female = 7.1:1; mean age was 61.2 (±9.7) years; Nine out of 49 (18.4%) patients were illiterate; Forty‑three out of 49 (87.8%) belonged to rural native place; Forty‑three out of 49 (87.7%) were smokers with 25 years as median pack‑years. Histological profile showed that adenocarcinoma (40.8%) was the predominant form followed by small cell carcinoma (32.7%). Time (median) delay in diagnosis was 3.0 days (home remedies/quack therapy), 60.0 days (primary/secondary level) and 8 days at tertiary level. Twenty seven of 49 patients (55.1%) presented in stage‑IV. Higher proportion of patients residing outside the district of study institute had longer delay in diagnosis but did not reach statistical significance (P > 0.05). The most important patient reasons for the delay in diagnosis was procrastinate/did not took symptoms seriously (19/49, 38.7%); no‑body to escort (13/49, 26.5%), long distance (5/49, 10.2%), financial constraints (4/49, 8.1%), preferred local practitioner (2/49, 4.0%), family commitment/marriage (2/49, 4.0%), fear of death (1/49, 2.0%) and no reason cited (3/49, 6.1%). Three patients were inadvertently diagnosed as tuberculosis and hence the delay.
Conclusion: Patient presented at a higher stage within a short span of time; however, there is scope of increasing health system capacity at primary/secondary level including sensitization training, health communication and appropriate referral to higher center.
Keywords: Behavior, health system, neoplasm, pathology, primary, secondary, smoking, social, time, tumor, tobacco
JEL Classification: I00
Suggested Citation: Suggested Citation