Delays in Diagnosis of Cervical Cancer Among Women Attending Tertiary Care Cancer Diagnostic Hospitals in Bhubaneswar, India

Abstract

Cervical cancer is one of the major causes of cancer deaths among women worldwide, with > 85% of the global burden of these cases and deaths occurring in developing countries. Delay in diagnosis of cervical cancer negatively impacts the prognosis and quality of life. The purpose of the study was to assess the different types of delays in cervical cancer diagnosis and identify the factors associated with the diagnostic delays. This cross-sectional study was undertaken in tertiary care cancer diagnostic hospitals of Bhubaneswar, the capital city of state Odisha during February–June 2018 including 122 women diagnosed with cervical cancer by histopathological examination. The mean age of the study respondents was 52.1 ± 10.9 years. The median total diagnostic delay was 68 days, and 48 (39.3%) patients had delayed diagnosis of cervical cancer. Among all the components, patient delay was the major contributor to the diagnostic delay. Multivariable analysis revealed that variables like lower education status of husband, patient’s positive history of sexually transmitted disease, non-attendance of screening program and not performing cervical/per speculum examination during initial consultation were significantly associated with longer diagnostic delays. There is an urgent need to shorten the diagnostic journey of the cervical cancer patients by addressing all the components of diagnostic delay and developing strategies to modify the factors associated with these delays.