A Hospital-Based Survey Assessing Facility-Level Factors Contributing to Late-Stage Cervical Cancer Diagnosis: A Mixed-Methods Approach.

<ns3:p>Background In Kenya, cervical cancer is the 2nd commonly diagnosed type of cancer and the top cause of cancer-related deaths among women. Over 50% of cervical cancer cases worldwide are diagnosed at a late stage, with this percentage rising to 80% in developing countries. Poor Health systems are major causes of late-stage diagnosis, leading to low survival rates and increased mortalities among cervical cancer patients. This study focused on determining the facility-level factors that contribute to late-stage diagnosis among cervical cancer patients. Methods An analytical cross-sectional mixed method study was conducted to collect data on hospital and referral systems experiences from 139 cervical cancer patients systematically sampled at Kenyatta National Hospital (KNH), using a semi structured questionnaire. In-depth interviews were conducted on 8 Key Informants. Associations between stage at diagnosis (dependent variable) and independent variables were tested using logistic regression at 95% Confidence Interval. Qualitative data was analyzed using content analysis method. Results Participants mean age was 51 years. 86 (61.9%) were diagnosed at advanced stages III and IV. A higher number of hospital referral instances, facing challenges during the referral process, and prolonged waiting times for diagnostic results were identified as key contributors to late-stage cervical cancer diagnosis. Conclusion Delays in diagnosis for most patients is due to poor health and referral systems. The study recommends improving referral systems and encouraging partnerships to decentralize cancer diagnostic.</ns3:p>