Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-30T15:55:14.888Z Has data issue: false hasContentIssue false
  • English
  • Français

Primary health care factors associated with late presentation of cancer in Saudi Arabia

Published online by Cambridge University Press:  24 May 2019

Abdulhadi Almuammar Open the ORCID record for Abdulhadi Almuammar [Opens in a new window]
Abdulhadi Almuammar*
Affiliation:
University of Sheffield, Western Bank, Sheffield, UK
*
Author for correspondence: Dr. Abdulhadi Almuammar, PhD, University of Sheffield, Western Bank, Sheffield, South Yorkshire S10 2TN, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Delays in the diagnosis of cancer were found to be a worldwide matter, and the early cancer detection has been targeted as a way to improve survival. Quantitative studies from Saudi Arabia reported a high number of cancer cases presenting at cancer centres for the first time with more advanced stages of the disease progression compared to Western countries without exploring the reasons for this phenomenon. Worldwide research identified several factors that contribute to delay in the diagnosis and treatment of cancer which were attributed to both patient and healthcare system. However, it was argued that variation in the operation of health systems and the socio-cultural context across countries makes it difficult to generalise findings beyond individuals’ countries. This necessitates country specific research to investigate why patients in Saudi Arabia present to cancer centres with late/advanced stages of their diseases.

Research aim and objectives:

The aim of this study is to identify and explore the factors that contribute to late-stage presentation of common cancers in Saudi Arabia. The main objective of this study is to understand the help seeking journey taken by patients with cancer from the time they discovered or felt their symptoms until the time they have their treatment initiated.

Methods:

Qualitative interviewing was used to collect data from 20 patients and 15 health professionals. The interviews were transcribed and then were subjected to the thematic analysis using a framework approach developed by Ritchie and Spencer (1994).

Results:

While some findings support what previous studies found as contributing factors responsible for delayed presentation of common cancers, this study identified several factors, which are believed to be country-specific. The ‘role of General Practitioner (GP)’, ‘challenges facing GPs’ and ‘ambiguity of the referral system’ were found to be factors that contribute to delay in the diagnosis and treatment of cancer in Saudi Arabia.

Conclusion:

This research identified several factors that need to be investigated in the future using quantitative methods. There is a need to investigate the extent of using alternative medicine and its possible association with late presentation of cancer.

Keywords

cancerhealth systemlate presentationprimary careSaudi Arabia
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 1 , March 2020 , pp. 71 - 75
Check for updates
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ezzat, A, Ibrahim, E, Raja, M, Al-Sobhi, S, Rostom, A, Stuart, R. Locally advanced breast cancer in Saudi Arabia: high frequency of stage III in a young population. Med Oncol 1999; 16 (2): 95–103.CrossRefGoogle Scholar
Al Rajhi, N, El Sebaie, M, Khafaga, Y, Al Zahrani, A, Mohamed, G, Al Amro, A. Nasopharyngeal carcinoma in Saudi Arabia: clinical presentation and diagnostic delay. East Mediterr Health J 2009; 15 (5): 1301–1307.Google ScholarPubMed
Aljebreen, A. Clinico-pathological patterns of colorectal cancer in Saudi Arabia: younger with an advanced stage presentation. Saudi J Gastroenterol 2007; 13 (2): 84–87.CrossRefGoogle ScholarPubMed
Walter, F, Webster, A, Scott, S, Emery, J. The Andersen model of total patient delay: a systematic review of its application in cancer diagnosis. J Health Serv Res Policy 2012; 17 (2): 110–118.CrossRefGoogle ScholarPubMed
Mitchell, E, Macdonald, S, Campbell, N, Weller, D, Macleod, U. Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic review. Br J Cancer 2007; 98 (1): 60–70.CrossRefGoogle Scholar
Macdonald, S, Macleod, U, Campbell, N, Weller, D, Mitchell, E. Systematic review of factors influencing patient and practitioner delay in diagnosis of upper gastrointestinal cancer. Br J Cancer 2006; 94 (9): 1272–1280.CrossRefGoogle ScholarPubMed
Ramirez, A, Westcombe, A, Burgess, C, Sutton, S, Littlejohns, P, Richards, MA. Factors predicting delayed symptomatic breast cancer: a systematic review. Lancet 1999; 353: 1127–1131.CrossRefGoogle ScholarPubMed
Macleod, U, Mitchell, E, Burgess, C, Macdonald, S, Ramirez, A. Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers. Br J Cancer 2009; 101: S92–S101.CrossRefGoogle ScholarPubMed
Smith, L, Pope, C, Botha, J. Patients’ help-seeking experiences and delay in cancer presentation: a qualitative synthesis. Lancet 2005; 366 (9488): 825–831.CrossRefGoogle ScholarPubMed
Neal, RD, Allgar, VL. Sociodemographic factors and delays in the diagnosis of six cancers: analysis of data from the ‘National survey of NHS patients: cancer’. Br J Cancer 2005; 92 (11): 1971–1975.CrossRefGoogle Scholar
de Nooijer, J, Lechner, L, de Vries, H. A qualitative study on detecting cancer symptoms and seeking medical help; an application of Andersen’s model of total patient delay. Patient Educ Couns 2001; 42 (2): 145–157.CrossRefGoogle ScholarPubMed
Kamangar, F. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006; 24 (14): 2137–2150.CrossRefGoogle Scholar
Evans, J, Ziebland, S, McPherson, A. Minimizing delays in ovarian cancer diagnosis: an expansion of Andersen’s model of ‘total patient delay’. Fam Pract 2006; 24 (1): 48–55.CrossRefGoogle ScholarPubMed
Montazeri, A, Ebrahimi, M, Mehrdad, N, Ansari, M, Sajadian, A. Delayed presentation in breast cancer: a study in Iranian women. Biomed Central Women’s Health 2003; 3, 4–12.CrossRefGoogle ScholarPubMed
Arndt, V. Provider delay among patients with breast cancer in Germany: a population based study. J Clin Oncol 2003; 21 (8): 1440–1446.CrossRefGoogle ScholarPubMed
Facione, N. Delay versus help seeking for breast cancer symptoms: a critical review of the literature on patient and provider delay. Soc Sci Med 1993; 36 (12): 1521–1534.CrossRefGoogle ScholarPubMed
Weller, D, Vedsted, P, Rubin, G, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer 2012; 106 (7): 1262–1267.CrossRefGoogle ScholarPubMed
Scott, S, Walter, F, Webster, A, Sutton, S, Emery, J. The model of pathways to treatment: conceptualization and integration with existing theory. Br J Health Psychol 2012; 18 (1): 45–65.CrossRefGoogle ScholarPubMed
Silverman, D. Interpreting Qualitative Data: Methods for Analysing Talk, Text and Interaction. London: Sage, 2003.Google Scholar
Ritchie, J, Spencer, L. Qualitative data analysis for applied policy research. In: Bryman, A, Burgess, RG (eds). Analyzing Qualitative Data. London: Routledge, 1994: 173–194.CrossRefGoogle Scholar
Lacey, A,Luff, D. Qualitative Research Analysis. Sheffield: The NIHR RDS for the East Midlands/Yorkshire & the Humber, 2007.Google Scholar
Andersen, R, Vedsted, P, Olesen, F, Bro, F, Søndergaard, J. Does the organizational structure of health care systems influence care-seeking decisions? A qualitative analysis of Danish cancer patients’ reflections on care-seeking. Scand J Prim Health Care 2011; 29 (3): 144–149.Google ScholarPubMed
Neal, RD, Ali, N, Atkin, K, Allgar, VL, Ali, S, Coleman, T. Communication between South Asian patients and GPs: comparative study using the Roter interactional analysis system. Br J Gen Pract 2006; 56 (532): 869–875.Google ScholarPubMed
Corner, J, Hopkinson, J, Roffe, L. Experience of health changes and reasons for delay in seeking care: a UK study of the months prior to the diagnosis of lung cancer. Soc Sci Med 2006; 62 (6): 1381–1391.CrossRefGoogle ScholarPubMed
Bain, N. Striking the right balance in colorectal cancer care—a qualitative study of rural and urban patients. Fam Pract 2002; 19 (4): 369–374.CrossRefGoogle ScholarPubMed
Almuammar, A, Dryden, C, Burr, J. Factors associated with late presentation of cancer: a limited literature review. J Radiother Pract 2010; 9 (02): 117–123.CrossRefGoogle Scholar
Molassiotis, A, Wilson, B, Brunton, L, Chandler, C. Mapping patients’ experiences from initial change in health to cancer diagnosis: a qualitative exploration of patient and system factors mediating this process. Eur J Cancer Care 2010; 19 (1): 98–109.CrossRefGoogle ScholarPubMed