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

Mauro Francisco Brito Filho; Mary Elizabeth de Santana; Clarissa Porfírio Mendes; Danilo de Jesus Costa; Carlos Alberto Andrade Serra Dos Santos; Márcio Flávio Moura de Araújo; Maria Aparecida Alves de Oliveira Serra

doi:10.1016/j.jcpo.2021.100277

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

J Cancer Policy. 2021 Jun:28:100277. doi: 10.1016/j.jcpo.2021.100277. Epub 2021 Feb 9.

Authors

Mauro Francisco Brito Filho¹, Mary Elizabeth de Santana¹, Clarissa Porfírio Mendes¹, Danilo de Jesus Costa², Carlos Alberto Andrade Serra Dos Santos³, Márcio Flávio Moura de Araújo⁴, Maria Aparecida Alves de Oliveira Serra⁵

Affiliations

¹ Universidade do Estado do Pará, Belém, Pará, Brazil.
² Programa de Pós-Graduação em Saúde e Tecnologia, Universidade Federal do Maranhão, Imperatriz, Maranhão, Brazil.
³ Universidade Estadual da Região Tocantina do Maranhão, Açailândia, Maranhão, Brazil.
⁴ Health Family Department, Oswaldo Cruz Foundation (FIOCRUZ), Eusébio, Brazil.
⁵ Programa de Pós-Graduação em Saúde e Tecnologia, Universidade Federal do Maranhão, Imperatriz, Maranhão, Brazil. Electronic address: maa.oliveira@ufma.br.

PMID: 35559906
DOI: 10.1016/j.jcpo.2021.100277

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Policy summary: 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.

Keywords: Delayed diagnosis; Gastric cancer; Health services accessibility; Healthcare disparities.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brazil / epidemiology
Cross-Sectional Studies
Delayed Diagnosis
Health Services Accessibility
Humans
Stomach Neoplasms* / diagnosis