Delays in diagnosis and treatment of lymphoma in Nepal: A cross-sectional study

ABSTRACT Background: Patients with lymphoma often seek care from multiple healthcare providers before receiving a diagnosis. Delays in timely referral result in many patients presenting at advanced stages, leading to poor outcomes, despite the fact that most lymphomas are treatable and curable. Objectives: The primary objective was to evaluate diagnostic and treatment intervals among patients with lymphoma. The secondary objectives were to identify factors contributing to delays and to document the common presenting symptoms. Materials and Methods: A descriptive, cross-sectional study was conducted in the Department of Clinical Oncology at Bir Hospital and Department of Hematology at Civil Service Hospital, Kathmandu, Nepal, between March 2024 and February 2025, after obtaining approval from the Institutional Review Board. Data on interval durations and most contributing factors were collected through face-to-face interviews using a structured questionnaire. Results: Among the 45 patients with lymphoma, diagnostic delays were identified in 35 (77.8%) cases, while 8 patients (17.8%) experienced treatment delays. The median diagnostic interval was 112 days (interquartile range (IQR): 123 days, range: 21-271 days), and the median treatment interval was 14 days (IQR: 14 days, range: 2-48 days). Diagnostic delay was linked to receiving empirical antitubercular therapy ( P , 0.042) and initially consulting informal healthcare providers ( P , 0.002), whereas treatment delay was more commonly observed among patients with no formal education ( P , 0.014). Conclusion: The majority of patients experienced a prolonged diagnostic interval. This finding highlights the urgent need to improve early detection, referral pathways, and diagnostic services to ensure timely diagnosis and better outcomes for patients with lymphoma.