Premium
Delays in diagnosis and treatment of childhood cancer in Indonesia
Author(s) -
Handayani K.,
Sitaresmi M. N.,
Supriyadi E.,
Widjajanto P. H.,
Susilawati D.,
Njuguna F.,
de Ven P. M.,
Kaspers G. J. L.,
Mostert S.
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26174
Subject(s) - medicine , childhood cancer , pediatrics , cancer , stage (stratigraphy) , health care , blood cancer , paleontology , economics , economic growth , biology
Abstract Background Emphasizing timely diagnosis and treatment of cancer are important themes in pediatric cancer management, as delays adversely impact survival. This study explores various delay types among children with cancer and determines factors that influence delays. Methods This cross‐sectional study was conducted at an Indonesian academic hospital. Parents of newly diagnosed patients were interviewed between October 2013 and September 2014 using semistructured questionnaires. Patient, physician, diagnosis, treatment, healthcare system (HCS), and total delay were analyzed. Results Parents of 145 children (response rate 89%) with cancer were interviewed. Median total delay was 70 days (range 5–4,055). Patient delay (median 5 days, range 0–189) was significantly shorter than HCS delay (median 49 days, range 4–4,025, P < 0.001). Diagnosis delay (median 58 days, range 3–4,015) was significantly longer than treatment delay (median 3 days, range 1–89, P < 0.001). Older age at diagnosis significantly lengthened patient delay ( P = 0.044). Using alternative treatment was associated with significantly longer patient and total delay ( P = 0.025, 0.024, respectively). Cancer type significantly influenced physician, diagnosis, treatment, HCS, and total delay ( P = 0.001, P = 0.004, P < 0.001, P < 0.001, P < 0.001, respectively). Neurological tumors had the longest delays, whereas hematological tumors had the shortest. Sex, parents’ education or income level, disease stage at diagnosis, health insurance status, distance from hospital, and first attended health‐facility type did not significantly impact the length of any delay type. Conclusions Healthcare providers need training to improve recognition of cancer symptoms and speed up subsequent diagnostic processes. Using alternative treatment increased patient and total delays. Community campaigns to encourage families to seek conventional cancer treatments are recommended.