Delay in diagnosis and treatment of cancer patients in some hospitals in Ankara: A cross-sectional study

In cancer, which is one of the most significant public health issues, early diagnosis and timely treatment are crucial for achieving better outcomes. This study aims to examine the delay reasons in the cancer care pathway related to i) the patient / community, ii) the disease, and iii) the healthcare provider and health system. This descriptive multicenter study was conducted using face-to-face surveys with 201 patients aged 18 and older who were diagnosed in 2022 and receiving treatment in chemotherapy units of tertiary hospitals in Ankara. Due to exclusion criteria, the results of 151 patients were included in the evaluation.The data from the surveys, filled out via Google Forms, were analyzed using SPSS 26.0 software. After descriptive and comparative analyses, binary logistic and multiple linear regression analyses were applied to examine the risk factors for delays, with delay durations considered as both categorical and continuous variables. A statistical significance level of p<0.05 was accepted. The median time from the first symptom to the first visit to a healthcare facility was 14 days, from the first visit to the first diagnostic procedure was 31 days, from the first diagnostic procedure to obtaining a microscopically confirmed diagnosis was 12.5 days, and from the microscopically confirmed diagnosis to the start of the first treatment was 13 days. The percentage distributions of these four individual periods throughout the entire process were 19.9%, 44.0%, 17.7%, and 18.4%, respectively. Significant factors for delays included: "patient-related causes" such as education level, number of children, and attempts to self-manage symptoms; "disease-related reasons" such as the type of malignancy by frequency; and "healthcare provider and system-related reasons" such as the number of diagnostic procedures and the status of the healthcare facility (private-public). In addition to regression analyses, many factors reported by patients, which can be addressed by three main reasons, were identified. It may be beneficial to raise awareness about health, disease, cancers and especially rare cancers and to determine a related health policy, to establish a referral system without adding a new burden to the existing system, and to develop a policy to close the gap in care quality between private and public health institutions.