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Estimates of delays in diagnosis of cervical cancer in Nepal

BACKGROUND: Cervical cancer is the leading cause of cancer related deaths among women in Nepal. The long symptom to diagnosis interval means that women have advanced disease at presentation. The aim of this study was to identify, estimate and describe the extent of different delays in diagnosis of c...

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Autores principales: Gyenwali, Deepak, Khanal, Gita, Paudel, Rajan, Amatya, Archana, Pariyar, Jitendra, Onta, Sharad Raj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3932513/
https://www.ncbi.nlm.nih.gov/pubmed/24533670
http://dx.doi.org/10.1186/1472-6874-14-29
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author Gyenwali, Deepak
Khanal, Gita
Paudel, Rajan
Amatya, Archana
Pariyar, Jitendra
Onta, Sharad Raj
author_facet Gyenwali, Deepak
Khanal, Gita
Paudel, Rajan
Amatya, Archana
Pariyar, Jitendra
Onta, Sharad Raj
author_sort Gyenwali, Deepak
collection PubMed
description BACKGROUND: Cervical cancer is the leading cause of cancer related deaths among women in Nepal. The long symptom to diagnosis interval means that women have advanced disease at presentation. The aim of this study was to identify, estimate and describe the extent of different delays in diagnosis of cervical cancer in Nepal. METHODS: A cross-sectional descriptive study was conducted in two tertiary cancer hospitals of Nepal. Face to face interview and medical records review were carried out among 110 cervical cancer patients. Total diagnostic delay was categorized into component delays: patient delay, health care providers delay, referral delay and diagnostic waiting time. RESULTS: Total 110 patients recruited in the study represented 40 districts from all three ecological regions of the country. Median total diagnostic delay was 157 days with more than three fourth (77.3%) of the patients having longer total diagnostic delay of >90 days. Out of the total diagnostic delay, median patient delay, median health care provider delay, median referral delay and median diagnostic waiting time were 68.5 days, 40 days, 5 days and 9 days respectively. Majority of the patients had experienced longer delay of each type except referral delay. Fifty seven percent of the patients had experienced longer patient delay of >60 days, 90% had suffered longer health care provider delay of >1 week, 31.8% had longer referral delay of >1 week and 66.2% had waited >1 week at diagnostic center for final diagnosis. Variation in each type of delay was observed among women with different attributes and in context of health care service delivery. CONCLUSIONS: Longer delays were observed in all the diagnostic pathways except for referral delay and diagnostic waiting time. Among the delays, patient delay is of crucial importance because of its longer span, although health care provider delay is equally important. In the context of limited screening services in Nepal, the efforts should be to reduce the diagnostic delay especially patient and health care provider delay for early detection and reduction of mortality rate of cervical cancer.
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spelling pubmed-39325132014-02-25 Estimates of delays in diagnosis of cervical cancer in Nepal Gyenwali, Deepak Khanal, Gita Paudel, Rajan Amatya, Archana Pariyar, Jitendra Onta, Sharad Raj BMC Womens Health Research Article BACKGROUND: Cervical cancer is the leading cause of cancer related deaths among women in Nepal. The long symptom to diagnosis interval means that women have advanced disease at presentation. The aim of this study was to identify, estimate and describe the extent of different delays in diagnosis of cervical cancer in Nepal. METHODS: A cross-sectional descriptive study was conducted in two tertiary cancer hospitals of Nepal. Face to face interview and medical records review were carried out among 110 cervical cancer patients. Total diagnostic delay was categorized into component delays: patient delay, health care providers delay, referral delay and diagnostic waiting time. RESULTS: Total 110 patients recruited in the study represented 40 districts from all three ecological regions of the country. Median total diagnostic delay was 157 days with more than three fourth (77.3%) of the patients having longer total diagnostic delay of >90 days. Out of the total diagnostic delay, median patient delay, median health care provider delay, median referral delay and median diagnostic waiting time were 68.5 days, 40 days, 5 days and 9 days respectively. Majority of the patients had experienced longer delay of each type except referral delay. Fifty seven percent of the patients had experienced longer patient delay of >60 days, 90% had suffered longer health care provider delay of >1 week, 31.8% had longer referral delay of >1 week and 66.2% had waited >1 week at diagnostic center for final diagnosis. Variation in each type of delay was observed among women with different attributes and in context of health care service delivery. CONCLUSIONS: Longer delays were observed in all the diagnostic pathways except for referral delay and diagnostic waiting time. Among the delays, patient delay is of crucial importance because of its longer span, although health care provider delay is equally important. In the context of limited screening services in Nepal, the efforts should be to reduce the diagnostic delay especially patient and health care provider delay for early detection and reduction of mortality rate of cervical cancer. BioMed Central 2014-02-17 /pmc/articles/PMC3932513/ /pubmed/24533670 http://dx.doi.org/10.1186/1472-6874-14-29 Text en Copyright © 2014 Gyenwali et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Gyenwali, Deepak
Khanal, Gita
Paudel, Rajan
Amatya, Archana
Pariyar, Jitendra
Onta, Sharad Raj
Estimates of delays in diagnosis of cervical cancer in Nepal
title Estimates of delays in diagnosis of cervical cancer in Nepal
title_full Estimates of delays in diagnosis of cervical cancer in Nepal
title_fullStr Estimates of delays in diagnosis of cervical cancer in Nepal
title_full_unstemmed Estimates of delays in diagnosis of cervical cancer in Nepal
title_short Estimates of delays in diagnosis of cervical cancer in Nepal
title_sort estimates of delays in diagnosis of cervical cancer in nepal
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3932513/
https://www.ncbi.nlm.nih.gov/pubmed/24533670
http://dx.doi.org/10.1186/1472-6874-14-29
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