A descriptive study on diagnostic timelines, and factors influencing delayed diagnosis among adult head and neck cancer patients at Uganda cancer institute.

Autor: Lalango F; Department of Ear, Nose and Throat, Moroto Regional Referral Hospital, P.O. Box 12, Moroto, Uganda. flalango311@gmail.com., Kabagenyi F; Department of Ear, Nose and Throat, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda., Seguya A; Department of Ear, Nose and Throat, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda., Byaruhanga R; Department of Ear, Nose and Throat, Uganda Christian University, P.O. Box 4, Mukono, Uganda., Otiti J; Surgical Oncology Division, Uganda Cancer Institute, P.O. Box 3935, Kampala, Uganda.
Jazyk: angličtina
Zdroj: World journal of surgical oncology [World J Surg Oncol] 2024 May 16; Vol. 22 (1), pp. 130. Date of Electronic Publication: 2024 May 16.
DOI: 10.1186/s12957-024-03407-4
Abstrakt: Background: Many patients with head and neck cancer (HNC) often present with advanced disease. This may result from delay in deciding to seek care, delay in reaching the healthcare facility and or delay in accessing care in the healthcare facility. We therefore set out to determine the time to definitive diagnosis and factors associated with delayed diagnosis among patients with HNC at the Uganda Cancer Institute (UCI).
Methods: A cross-sectional study was conducted at UCI, patients with HNC were recruited. An interviewer administered questionnaire was used to collect data on sociodemographic factors and clinical characteristics, including timelines in months, from symptom onset to deciding to seek care, to reaching the health care facility and to definitive diagnosis. Multivariate Poisson regression analysis was used to calculate odds ratios (ORs) for the factors of association with delayed diagnosis.
Results: We recruited 160 HNC patients, and 134 patients were analyzed. The median age was 49.5 years (IQR 26.5), 70% (94 of 134) were male, 48% (69 of 134) had below secondary school education, 49% (65 of 134) had a household income < 54 USD. 56% (76 of 134) were sole bread winners, 67% (89 of 134) had good access road condition to the nearest health unit and 70% (91 of 134) presented with tumor stage 4. Median time from onset of symptoms to definitive diagnosis was 8.1 months (IQR 15.1) and 65% (87 of 134) of patients had delayed diagnosis. Good access roads (aOR: 0.26, p = 0.006), secondary school education (aOR: 0.17, p = 0.038), and household income > 136 USD (aOR: 0.27, p = 0.043) were associated with lower odds of delayed diagnosis. Being the sole bread winner (aOR: 2.15, p = 0.050) increased the odds of delayed diagnosis.
Conclusion: Most of HNC patients (65%) at UCI had delayed diagnosis. A national care pathway for individuals with suspected HNC should be established and consider rotation of Ear, Nose and Throat surgeons to underserved regions, to mitigate diagnostic delay.
(© 2024. The Author(s).)
Databáze: MEDLINE
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