Do Time, distance and economic factors influence stage of presentation of malignancies?? Experience from a Regional cancer center in India

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cancer Care Delivery in Low Resource Environments
Bioethics, Legal, and Economic Issues
Presenter Nagarjun Ballari
Citation Annals of Oncology (2018) 29 (suppl_9): ix121-ix123. 10.1093/annonc/mdy442
Authors N.R. Ballari, T. Jindia, L. Annam, R. Miriyala, S. Ghoshal
  • Radiotherapy & Oncology, PGIMER, 160012 - Chandigarh/IN

Abstract

Background

Universal health coverage (UHC), is the aim of a developing health economy such as India. The baseline availability of socioeconomic information is a prerequisite to achieve UHC. The majority of patients present to us in locally advanced and advanced stages. We tried to analyze the socio-economic and demographic variables, such as distance travelled and time taken to reach the RCC and their influence on stage of presentation.

Methods

Apart from the standard details usually recorded about a cancer patient in our cancer registry, we prospectively collected details of source of income, reimbursement, and distance of residence from RCC from patients who were registered at our RCC between August 2017- September 2017. We then anaylzed these factors in an attempt to identify possible correlations. Statistical correlation was identified using student’s t test.

Results

Among 591 patients analyzed, 384 (64%) of patients presented with advanced and locally advanced stage disease while 114 (19%) patients presented to us with early stage disease. The median time taken for the patient to reach the RCC from permanent residence after the beginning of cancer related complaints was 3.19 months, and 49.5% of patients with advanced stage disease presented at a time interval of greater than 3.1 months. The median distance travelled to reach the RCC was 131 km. More than 50% of patients with advanced stage disease came to the RCC from a distance greater than 131 km. The source of income was private employment for 223 patients, government employment for 164 patients, and self-employment for 200 patients. Only 164 patients had some kind of structured health scheme to manage their health care expenses. Among these, 96 patients had private insurance/reimbursement and 64 patients had government reimbursement. However, a correlation between delay in presentation to the RCC, distance travelled to reach the RCC, source of income and advanced stage of disease could not be established.

Conclusions

The majority of patients visiting our RCC travel from far off places and most of these patients pay for the cancer treatment themselves without any support from government or private insurances. All these factors may be responsible for late or advanced stage presentation of cancer patients.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Dr Nagarjun Ballari.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.