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

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.

Cervical Cancer and Human Papillomavirus Awareness among Women in Saudi Arabia

“…Nation-wide data regarding the prevalence of CC or abnormal pap smears, as well as the awareness or implementation of the HPV vaccine, are limited for multiple reasons; for example, access to a health system for cancer cases is not always easy, and there is a lack of national screening programs where CC cases can be discovered in their early stages. Furthermore, not all advanced cervical cancer cases are registered; the patient might die before proper diagnosis, as one of the major health issues in Saudi Arabia is the late presentation of cancer cases, and the culture barriers against postmortem diagnostic autopsies [9,10]. Unfortunately, most women in developing countries, including Saudi Arabia, present with clinically advanced stages requiring extensive survival treatment, including surgery, radiotherapy, and chemotherapy [11].…”

Healthcare practices that increase the quality of care in cancer trajectories from a general practice perspective: a scoping review

“…To provide effective and evidence-based quality of care, continuous medical education for early cancer diagnostics should be aimed at specific cancer types [ 29–32 ]. Time constraints in general practice can be a barrier to timely , efficient , and people-centered healthcare; thus, negatively influencing both the GPs ability to listen to the patients’ full story and their decision to perform a thorough physical examination, and makes it difficult for patients to get an appointment [ 27 , 31 , 33 ].…”

“…For most cancer patients, their GP was their first healthcare contact in their cancer trajectories. Thus, people-centered quality of care is increased when the GP investigates whether their patients feel that their symptoms are being taken seriously and whether their patients suspect that their symptoms could be cancer-related [ 31 , 32 , 37 ].…”

Interventions to improve early cancer diagnosis of symptomatic individuals: a scoping review

“…Three articles were from Denmark, 26 39 41 two from the UK 35 70 and one each from Canada, 59 Norway, 49 Sweden, 63 Spain 12 and Saudi Arabia. 11 The publications were on adult patient populations with one also involving paediatric patients. The focus and metrics for assessment of the effectiveness of the pathways varied across the publications.…”