Patient delay and related influencing factors in Chinese women under 35 years diagnosed with cervical cancer: A cross-sectional study

Jun Ma; Yang Luo; Shengbo Yang; Xiangyu Liu; Yueyang Peng; Honghong Wang; Maritta Valimaki; Can Gu

doi:10.1016/j.apjon.2022.100165

Patient delay and related influencing factors in Chinese women under 35 years diagnosed with cervical cancer: A cross-sectional study

Asia Pac J Oncol Nurs. 2022 Nov 15;10(2):100165. doi: 10.1016/j.apjon.2022.100165. eCollection 2023 Feb.

Authors

Jun Ma¹, Yang Luo¹, Shengbo Yang², Xiangyu Liu³, Yueyang Peng¹, Honghong Wang¹, Maritta Valimaki^{1

4

5}, Can Gu¹

Affiliations

¹ Xiangya School of Nursing, Central South University, Changsha, China.
² Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China.
³ Health Service Centre, Hunan Tumor Hospital, Central South University, Changsha, China.
⁴ Xiangya Center for Evidence-Based Practice & Healthcare Innovation: A Joanna Briggs Institute Affiliated Group, Central South University, Changsha, China.
⁵ Department of Nursing Science, University of Turku, Turku, Finland.

Abstract

Objective: Patient delay was defined as an interval between the discovery of the initial symptoms and diagnosis, which was longer than 90 days. This study aimed to determine the patient delay rate and related factors in women with cervical cancer in Hunan province, South-Central China.

Methods: A cross-sectional study was conducted among 140 women with cervical cancer aged <35 years from October, 2019 to March, 2021. Assumptions in Andersen Behavioral Model of Health Services Utilization were used to measure the factors influencing patient delay. Logistic regression models were used to identify factors associated with patient delay. A P-value of <5% was considered significant.

Results: A total of 57 (40.71%) young women with cervical cancer had patient delay, with an average delay time of 178.70 (307.90) days. Predisposing factors, such as religion, unemployment, health beliefs related to cancer screening, and a history of cervical cancer screening within 2 years or more (P < 0.05), were associated with patient delay. Enabling factors, such as distance to the nearest medical facility and type of the nearest medical facility, were associated with a reduced likelihood of patient delay. With the need-for-care factor, young women who experienced vaginal pain after or during intercourse had a higher risk (adjusted odds ratio, 33.48; 95% confidence interval, 3.22-348.68, P = 0.003) of patient delay.

Conclusions: These findings reinforce the need for programs to enhance knowledge and awareness about cervical cancer screening and the importance of early diagnosis in women to help eliminate cervical cancer in China by 2050.

Keywords: Cervical cancer; Influence factors; Patient delay; Under 35 years old; Young women.