DELAYED cancer diagnosis is a persistent problem, leading to poorer outcomes for patients, according to a research study presented at the European Society for Medical Oncology (ESMO) Asia 2016 Congress in Singapore last week.
In the study of cancer patients at the Department of Radiotherapy and Oncology in Chandigarh, India, researchers found that patients waited an average of four months before seeking a cancer diagnosis, with some patients waiting as long as three years before visiting a doctor.
“Delaying diagnosis had a significant impact on the treatment eventually received by patients in our study,” said lead author Dr. Raviteja Miriyala, senior resident at the Department of Radiotherapy and Oncology of the Postgraduate Institute of Medical Education and Research in Chandigarh. “Patients with longer delays before diagnosis were more likely to receive palliative, rather than curative, treatment because they had advanced disease—and were likely to have poorer outcomes.”
Early diagnosis and treatment improve the outcome of most cancers.
The study also examined the time interval between diagnosis and the start of treatment for the patients, and found that doctors also contributed to delays, with primary care physicians adding an average of three weeks’ delay, and oncologists contributing an average of 10 days’ delay. Altogether, the average total delay between the first symptom and the initiation of treatment was about six months, the study said.
“Patients were found to be the source of most delays in diagnosis—some waited less than a week before seeing a doctor but others waited three years. Less educated patients were significantly less likely to get an early consultation with their doctor than those with higher education. Campaigns are needed to increase patient awareness about symptoms and screening,” Dr. Miriyala said.
Patients with longer delays were significantly more likely to receive palliative treatment than those with shorter delays, the study said.
“Outcomes were not evaluated in our study but it is common knowledge that treatment with palliative intent leads to inferior outcomes compared to that with curative intent. Our research suggests that reducing delays might improve outcomes for cancer patients,” Dr. Miriyala added.
In separate comments on the findings, Dr. Sing-Huang Tan, senior consultant for the Department of Hematology-Oncology at the National University Cancer Institute, Singapore (NCIS), said, “Patients may delay seeking medical care because of failure to recognize symptoms, family or work commitments, or anxiety and fear. Patients in certain parts of Asia in particular may have ingrained cultural beliefs or preferences to self-medicate with traditional treatments, poor access to healthcare, or socioeconomic limitations which could hypothetically lead to long delays before seeing a doctor.”
Dr. Tan stressed that education was the key to improving cancer diagnosis and treatment.
“This study highlights the perils of diagnostic delays and how they can lead to changes in treatment intent and presumably ultimately affect cancer outcomes,” he said. “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.”