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Reliance on Self-Medication Increase Delays in Diagnosis and Management of GI Cancers: Results From Nepal

PURPOSE: Patients with GI cancers in Nepal often present with advanced disease and poor outcomes. The purpose of the study was to determine the time to presentation, diagnosis, and treatment of GI cancer and the baseline factors that may be associated with delays. PATIENTS AND METHODS: An institutio...

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Autores principales: Dulal, Soniya, Paudel, Bishnu Dutta, Wood, Lori Anne, Neupane, Prakash, Shah, Aarati, Acharya, Bibek, Shilpakar, Ramila, Acharya, Sandhya Chapagain, Karn, Ambuj, Poudel, Bishal, Thapa, Rameej Revanta, Acharya, Albira, Martin, Michael Gary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society of Clinical Oncology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456311/
https://www.ncbi.nlm.nih.gov/pubmed/32762562
http://dx.doi.org/10.1200/GO.20.00202
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author Dulal, Soniya
Paudel, Bishnu Dutta
Wood, Lori Anne
Neupane, Prakash
Shah, Aarati
Acharya, Bibek
Shilpakar, Ramila
Acharya, Sandhya Chapagain
Karn, Ambuj
Poudel, Bishal
Thapa, Rameej Revanta
Acharya, Albira
Martin, Michael Gary
author_facet Dulal, Soniya
Paudel, Bishnu Dutta
Wood, Lori Anne
Neupane, Prakash
Shah, Aarati
Acharya, Bibek
Shilpakar, Ramila
Acharya, Sandhya Chapagain
Karn, Ambuj
Poudel, Bishal
Thapa, Rameej Revanta
Acharya, Albira
Martin, Michael Gary
author_sort Dulal, Soniya
collection PubMed
description PURPOSE: Patients with GI cancers in Nepal often present with advanced disease and poor outcomes. The purpose of the study was to determine the time to presentation, diagnosis, and treatment of GI cancer and the baseline factors that may be associated with delays. PATIENTS AND METHODS: An institutional review board–approved study was performed in Kathmandu, Nepal, from July 2018 to June 2019. Patients with newly diagnosed GI cancers were asked to fill out a standardized questionnaire. Baseline factors such as residence, literacy, and use of self-medication were recorded. Patients were asked to report the time from first symptom to presentation, time from primary care visit to pathologic diagnosis, and time from diagnosis to surgery and/or treatment. Baseline factors were analyzed using 2-tailed t tests (Prism 8.0; GraphPad, La Jolla, CA) to determine whether any factors were associated with longer time delays in these 3 intervals. RESULTS: The cohort comprised of 104 patients with a median age of 53.5 years (range, 22-77 years); 61.5% were men, 46.2% had upper GI cancers, and 83.7% presented with stage III or IV disease. The median time to presentation was 150 days, time to diagnosis was 220 days, and time to treatment was 50 days. There was no statistically significant difference in time intervals between upper and lower GI cancers. Use of self-medication (88.5%) was the only factor associated with longer time intervals to presentation, diagnosis, and treatment. CONCLUSION: Patients in Nepal have long time intervals to presentation, diagnosis, and treatment of GI cancer. Self-medication led to longer delays. Reasons for self-medication and other potential barriers will be explored in future studies in the hopes of improving outcomes.
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spelling pubmed-74563112020-10-05 Reliance on Self-Medication Increase Delays in Diagnosis and Management of GI Cancers: Results From Nepal Dulal, Soniya Paudel, Bishnu Dutta Wood, Lori Anne Neupane, Prakash Shah, Aarati Acharya, Bibek Shilpakar, Ramila Acharya, Sandhya Chapagain Karn, Ambuj Poudel, Bishal Thapa, Rameej Revanta Acharya, Albira Martin, Michael Gary JCO Glob Oncol Original Reports PURPOSE: Patients with GI cancers in Nepal often present with advanced disease and poor outcomes. The purpose of the study was to determine the time to presentation, diagnosis, and treatment of GI cancer and the baseline factors that may be associated with delays. PATIENTS AND METHODS: An institutional review board–approved study was performed in Kathmandu, Nepal, from July 2018 to June 2019. Patients with newly diagnosed GI cancers were asked to fill out a standardized questionnaire. Baseline factors such as residence, literacy, and use of self-medication were recorded. Patients were asked to report the time from first symptom to presentation, time from primary care visit to pathologic diagnosis, and time from diagnosis to surgery and/or treatment. Baseline factors were analyzed using 2-tailed t tests (Prism 8.0; GraphPad, La Jolla, CA) to determine whether any factors were associated with longer time delays in these 3 intervals. RESULTS: The cohort comprised of 104 patients with a median age of 53.5 years (range, 22-77 years); 61.5% were men, 46.2% had upper GI cancers, and 83.7% presented with stage III or IV disease. The median time to presentation was 150 days, time to diagnosis was 220 days, and time to treatment was 50 days. There was no statistically significant difference in time intervals between upper and lower GI cancers. Use of self-medication (88.5%) was the only factor associated with longer time intervals to presentation, diagnosis, and treatment. CONCLUSION: Patients in Nepal have long time intervals to presentation, diagnosis, and treatment of GI cancer. Self-medication led to longer delays. Reasons for self-medication and other potential barriers will be explored in future studies in the hopes of improving outcomes. American Society of Clinical Oncology 2020-08-07 /pmc/articles/PMC7456311/ /pubmed/32762562 http://dx.doi.org/10.1200/GO.20.00202 Text en © 2020 by American Society of Clinical Oncology https://creativecommons.org/licenses/by-nc-nd/4.0/ Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Reports
Dulal, Soniya
Paudel, Bishnu Dutta
Wood, Lori Anne
Neupane, Prakash
Shah, Aarati
Acharya, Bibek
Shilpakar, Ramila
Acharya, Sandhya Chapagain
Karn, Ambuj
Poudel, Bishal
Thapa, Rameej Revanta
Acharya, Albira
Martin, Michael Gary
Reliance on Self-Medication Increase Delays in Diagnosis and Management of GI Cancers: Results From Nepal
title Reliance on Self-Medication Increase Delays in Diagnosis and Management of GI Cancers: Results From Nepal
title_full Reliance on Self-Medication Increase Delays in Diagnosis and Management of GI Cancers: Results From Nepal
title_fullStr Reliance on Self-Medication Increase Delays in Diagnosis and Management of GI Cancers: Results From Nepal
title_full_unstemmed Reliance on Self-Medication Increase Delays in Diagnosis and Management of GI Cancers: Results From Nepal
title_short Reliance on Self-Medication Increase Delays in Diagnosis and Management of GI Cancers: Results From Nepal
title_sort reliance on self-medication increase delays in diagnosis and management of gi cancers: results from nepal
topic Original Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456311/
https://www.ncbi.nlm.nih.gov/pubmed/32762562
http://dx.doi.org/10.1200/GO.20.00202
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