THE SYMPTOM –TO–TREATMENT DELAY IN CARCINOMA CERVIX: WHERE WE STAND AMONG DEVELOPING COUNTRIES

Dr.Abhishek Shrivastava; Dr.Veenita Yogi; Dr.O.P.Singh; Dr.Varsha Mandloi; Dr.Megha Choudhary

Volume : VII, Issue : IX, September - 2018

THE SYMPTOM –TO–TREATMENT DELAY IN CARCINOMA CERVIX: WHERE WE STAND AMONG DEVELOPING COUNTRIES

Dr. Abhishek Shrivastava, Dr. Veenita Yogi, Dr. O. P. Singh, Dr. Varsha Mandloi, Dr. Megha Choudhary

Abstract :

AIM: The aim of this study is to analyse the relationship between the time delays from the first symptom to the time of definitive treatment in patients of cervical cancer.

MATERIAL &METHOD: 413 patients with cancer cervix were analysed retrospectively and prospectively between January 2013 and June2017 at Department of Radiotherapy and Oncology, Gandhi Medical College Bhopal.

Patients were interviewed at their first presentation to our hospital. Dates were recorded according to the patient�s recollection, written information in the doctor�s records during diagnosis process, and the hospital files. Details from the patient�s first symptoms and course of diagnosis and treatment were recorded.

The overall delay in months was recorded from appearance of the first symptoms to the date when the patient was started with definitive cancer specific treatment (end point), and this delay was divided as : (1) time of appearance of the first symptom to first contacting the health care system (patient delay). (2) time from first contacting the healthcare system to histopathological diagnosis (histopathological delay). (3) time from histopathological diagnosis to the end point (treatment delay).

RESULTS: Median age was 49 years. Most common symptoms were bleeding per vagina in 93%patients, white discharge in 89%patients, and abdominal pain in 80%patients .The mean delay from first symptom to end point was145 days. Total symptom– to–treatment was due to: patient delay (85.7%), histopathological delay (7.2%), and treatment delay (7.1%).

CONCLUSION: Patient delay is the most important factor. Personal care, community education programs and socioeconomic support may help in their early presentation to the hospital for better Quality of life.