UICC World Cancer Congress 2006

Objective: In developing countries cancer patients are in advanced stage of their disease by the time they receive anti cancer therapy. Despite Rapid medical advances & cancer awareness campaigns the scenario has not changed much. The objective of the study was to identify the factors causing delay in cancer management.

Methods: We evaluated 1004 cancer patients attending the department of Surgical Oncology Regional Cancer Center, Rohtak (India) between April 2000 – April 2003. Details of presentation interval, diagnostic interval & treatment interval were noted besides the literacy level and cancer awareness of the patients. Qualification of the Primary Care Physicians, time spent by them in examining the patient was also recorded.

Results: 43.7% of the patients were labour class. 61.9% of the patients were illiterate and 74.7% had no awareness about cancer. 678 (67.3%) presented to their physicians without any delay i.e within one month. In 68.4% patients the diagnostic interval was delayed by more than one month..At this level, physician was the most common factor responsible for delay in 60.4% of the patients. The physicians were classified as qualified medical practitioners (47.8%), qualified non medical practitioners (8.6%) and unqualified medical practitioners (43.6%). Not only 93% of the unqualified physicians delayed the diagnosis but even 58% of the qualified physicians delayed the diagnosis. Primary care physician spent less than 5 minutes during first consultation and only 46% of them performed relevant physical examination of the patient.