Seenu V, Kole Pratibha, Dhabal Suman
Department of Radiation Oncology, Burdwan Medical College, Purba Bardhaman, West Bengal, India.
South Asian J Cancer. 2024 Apr 15;14(1):81-85. doi: 10.1055/s-0044-1786003. eCollection 2025 Jan.
Cancer patients often present after a period of certain delay from onset of symptoms. By tradition, alternate medicine has been the commonly sought after remedy for them. The objective of this study was to evaluate the delay in presentation to a cancer care facility, with respect to advanced stage at diagnosis and the use of alternate medicine. A cross-sectional study was undertaken in a tertiary care hospital from eastern India over 5 months where patients with cytological or histological proof of malignancy were interviewed using a pretested questionnaire. Comparative analysis was done with cross tables along with Kruskal-Wallis test for association between delay and the independent variables (demographic parameters and alternate medicine usage). Predictors for delay were assessed with logistic regression analysis. Spearman's rank test was used to measure the direction and strength of correlation of delay and alternate medicine use against stage at presentation. One-thousand twenty-two subjects were interviewed of whom 61.44% presented in advanced stage (either stage III and IV). About 56.1% patients had 4 to 6 months delay, while 19.1% patients presented after more than 6 months. About 27.5% patients had history of initial alternate medicine usage. Progressive increase in subjects presenting in advanced stage was observed with corresponding increase in delay, from 62.63% in more than 1 month delay to 80.48% in more than 3-month delay and 98.47% in those having more than 6-month delay. More of alternate medicine users presented with significant delay versus who did not (96.08 vs. 67.34% for >3 months delay) and the difference further increased with longer delay. About 89.67% of those who had used alternate medicine presented in advanced stage. Among them, this percentage progressively escalated with increase in delay period. Positive correlation between delay (ρ = 0.742 for total sample) and (ρ = 0.592 for alternate medicine users) advanced stage was observed. This study found a considerably high occurrence of delay in presentation among cancer patients after onset of symptoms. This delay was strongly associated with advanced stage at diagnosis and alternate medicine use initially. It provides substantial information to formulate policies for implementing awareness on symptoms of cancer and benefits of its early detection.
癌症患者通常在出现症状后的一段时间后才前来就诊。按照传统，替代医学一直是他们普遍寻求的治疗方法。本研究的目的是评估在癌症治疗机构就诊的延迟情况，以及诊断时的晚期阶段和替代医学的使用情况。在印度东部的一家三级护理医院进行了一项为期5个月的横断面研究，使用预先测试的问卷对有细胞学或组织学恶性肿瘤证据的患者进行访谈。使用交叉表以及Kruskal-Wallis检验对延迟与自变量（人口统计学参数和替代医学使用情况）之间的关联进行比较分析。通过逻辑回归分析评估延迟的预测因素。使用Spearman秩检验来衡量延迟和替代医学使用与就诊时阶段之间的相关性方向和强度。共访谈了1022名受试者，其中61.44%处于晚期（III期和IV期）。约56.1%的患者延迟4至6个月，而19.1%的患者在6个月以上才前来就诊。约27.5%的患者有最初使用替代医学的病史。观察到晚期就诊的受试者比例随着延迟时间的相应增加而逐渐上升，从延迟超过1个月的62.63%增加到延迟超过3个月的80.48%，以及延迟超过6个月的98.47%。与未使用替代医学的患者相比，更多使用替代医学的患者出现了显著延迟（延迟超过3个月的分别为96.08%和67.34%），并且随着延迟时间延长，差异进一步增大。约89.67%使用替代医学的患者处于晚期。其中，这一比例随着延迟期的增加而逐渐上升。观察到延迟（总样本的ρ = 0.742）与晚期阶段（替代医学使用者的ρ = 0.592）之间存在正相关。本研究发现，癌症患者出现症状后就诊延迟的发生率相当高。这种延迟与诊断时的晚期阶段和最初使用替代医学密切相关。它为制定关于癌症症状意识和早期检测益处的宣传政策提供了大量信息。
