Duration of intervals in the care-seeking pathway of lung cancer in Nepal.

Abstract

Introduction: Patients with lung cancer in Nepal often present at an advanced stage. The purpose of this study was to determine the access, diagnostic and treatment intervals in patients with lung cancer and to identify factors that may be causing the delays leading to advanced presentation.

Methods: This was a descriptive, cross-sectional study conducted in the Department of Clinical Oncology, Bir Hospital from July 2023 to April 2024 after obtaining ethical approval from the Institutional Review Board. Patients with newly diagnosed lung cancer were interviewed and data was collected. Data were presented in the forms of percentages and mean/median. Univariate and multivariate logistic regression analysis was done to assess the association between various factors and different delays.

Results: Of the 100 patients included, 56% were men and the mean age was 64.5 ± 10.8 years. 64% of the patients had stage IV disease. The median access, diagnostic and treatment interval were 44.5 days, 45.5 days and 26 days, respectively. Access, diagnostic and treatment delays were seen in 72%, 63% and 42% of the patients, respectively. Receiving empirical anti-tubercular treatment and visiting informal healthcare providers as their first healthcare contact was associated with diagnostic delay whereas smoking was associated with treatment delay.

Conclusion: There is a significant delay in the care-seeking pathway of lung cancer in Nepal. Implementing corrective measures to address these could help improve the outcomes for these patients.