Cultural, social, and healthcare access factors associated with delays in gastric cancer presentation, diagnosis, and treatment: A cross-sectional study

• Published in: Journal of cancer policy 2021-06, Vol.28, p.100277-100277, Article 100277
• Main Authors: Filho, Mauro Francisco Brito, Santana, Mary Elizabeth de, Mendes, Clarissa Porfírio, Jesus Costa, Danilo de, Santos, Carlos Alberto Andrade Serra dos, Araújo, Márcio Flávio Moura de, Oliveira Serra, Maria Aparecida Alves de
• Format: Article
• Language: English
• Subjects: Delayed diagnosis; Gastric cancer; Health services accessibility; Healthcare disparities
• ISSN: 2213-5383; 2213-5383
• DOI: 10.1016/j.jcpo.2021.100277

[Display omitted] •The delay in the treatment of gastric cancer was associated with the delay in scheduling an appointment with a specialist doctor and the lack of hospital beds.•Patients with no comorbidities took longer to have an appointment with an oncologist.•Unemployed patients have spent more time between diagnosis and gastric cancer treatment The aim of this study was to identify the time intervals between the demand for health services and the initiation of cancer treatment, and to explore the associated factors, in gastric cancer patients being treated in an oncology hospital in northern Brazil. This cross-sectional study. Gastric cancer patients receiving treatment in a northern Brazil reference hospital were interviewed. A Mann-Whitney test was used to verify associations between the time intervals of access to treatment and socioeconomic factors, clinical variables, and patient difficulties, adopting a 0.05 significance level. The average time intervals were 471.3 days between symptom onset and primary health service request and 180.9 days between diagnosis and treatment. The average time between the onset of symptoms and the treatment of gastric cancer was 747.8 days. Patients using herbal home remedies showed the longest times before seeking primary health care (p = 0.04). Delays between diagnosis and treatment were associated with unemployment (p = 0.03). High average times until oncologist appointments were related to the absence of comorbidities (p = 0.004). Personal difficulties and a lack of hospital beds were associated with long time intervals to specialist appointments and between diagnosis and treatment. Personal difficulties were associated with long time intervals between the onset of symptoms and the treatment of gastric cancer. Gastric cancer patients faced delays and healthcare access barriers in a region with high mortality for this disease. Appropriate interventions are necessary to reduce delays and better control the disease. In this paper we have explored the barriers to access to diagnosis and treatment for patients with gastric cancer in a major cancer centre in Northern Brazil. The results will inform strategies for improving timely access to critical cancer services.