Factors influencing delay in diagnosis of head and neck cancers at the university teaching hospital of Kigali (CHUK)

Abstract

Background: HNCs are major health problem in developing countries. Delayed diagnosis of HNCs is associated with advanced stage of disease with high morbidity and mortality. Objectives: Our study aimed at evaluating the factors associated with delayed diagnosis of HNCs at the University Teaching Hospital of Kigali (CHUK). Patients and method: This cross-sectional prospective study was conducted at CHUK for a period of 18 months (March 2021-August 2022). It enrolled 81 participants with positive histology results for HNCs who consulted at CHUK during the study period. Patients’ information was recorded using a pre-established questionnaire and analyzed using Epidata 3.1 software. Statistical Package for the Social Sciences 25.0 was used in processing and analysis of data. Chi-square test and p-values = 0.05 was used during comparison of variables. Results: Male accounted for 53% with ages ranging from 1-91 years. 30% of the patients came from Northern Province. Majority of our patients (71%) did not attend school or did primary level and were farmers (39.5%). Most of patients (60%) are diagnosed at late stage (Stage III&IV) and the most common patient-related factors for delay were: financial constraints in (35.4%), lack of awareness in (17%), long distance to reach at tertiary hospital in (81%) and history of use of traditional medicines in (56%). Health care provider-related factors were: shortage of specialized workforce and health infrastructures causing histology delay, imaging delay, delay due to theatre space and delay referral from district hospitals and health centers. Conclusion: There is a delay in diagnosis for HNCs patients at CHUK and central factors include patients-related, health care providers-related factors and health system.