Determinants of delay in presentation to completion of treatment in cervical cancer

To assess the time taken between onset of symptoms to consultation with health care provider to the diagnosis of cervical cancer to initiation of treatment and completion of treatment. Secondary outcome was to analyze the various factors associated with the delay. A prospective observational study was undertaken in a tertiary cancer center in North East India from 1st January 2023 to 31st December 2023. Time delay in presentation, diagnosis and treatment initiation and completion were studied and factors pertaining to the various delays were assessed. A total of 101 patients were included in the study. The median age of the patients was 51 years. The median delay in presentation, diagnosis, initiation and completion of treatment was 60 days, 7 days,28 days and 56 days respectively. The majority of women (77%) acknowledged they did not know abnormal vaginal bleeding was a red flag sign of cancer and none of them had undergone any screening test to detect cervical cancer. Sixty per cent of women had availed government insurance schemes. On univariate analysis, it was found age > 50 years, absence of prior gynaecology check-up, poor awareness and "quack" consultations have been associated with delayed presentation(p < 0.05). However, disease apprehension, people living below the poverty line and referral to higher diagnostic centers for advanced imaging were associated with delayed initiation and completion of treatment (p < 0.05). Increased awareness about cervical cancer, better percolation of cancer screening knowledge among public, improvement of diagnostic facilities and better utilization of insurance schemes are the need of the hour in this part of the country to keep the journey to the WHO 2030 goal of cervical cancer elimination running on time without any hassles.