Type of cancer and complementary and alternative medicine are determinant factors for the patient delay experienced by children with cancer: A study in West Java, Indonesia

Abstract

Introduction Most pediatric cancer patients in developing countries present at an advanced stage due to delayed diagnosis, being an important barrier to effective care. The objective of this study was to evaluate the associated factor of patient delay and explore significant parental practice‐associated risk factor to patient delay. Methods This was a sequential mixed methodology, utilizing data from the Indonesian Pediatric Cancer Registry for clinical variables and completed interviews with parents using structured questionnaires to obtain their sociodemographic data. A binary logistic regression analysis model was fitted to identify factors associated with patient delay. Additional semi‐structured interviews related to parental practice of using complementary and alternative medicine (CAM) were administered to 30 parents. Thematic framework analysis was performed on qualitative data to explore determinant factors of parental practice of using CAM. Results We interviewed 356 parents with children with cancer. The median patient delay was 14 days (interquartile range [IQR]: 6–46.5 days). The most extended delay was in patients with malignant bone tumors (median 66, IQR: 14–126). In multivariable logistic regression analysis, solid cancer (odds ratio [OR] = 5.22, 95% confidence interval [CI]: 2.79–9.77, p < .001) and use of CAM (OR = 1.86, 95% CI: 1.13–3.08, p = .015) were associated with patient delay. Qualitative interviews highlighted key issues relative to determinant parental factors using CAM, including vague initial childhood cancer symptoms, parental health‐seeking behavior, CAM availability and accessibility, also barriers of healthcare facilities. Conclusion Type of cancer and use of CAM are essential factors that cause patient delay. It should be addressed in the future childhood cancer awareness and childhood cancer diagnosis pathway.

Complementary and Alternative Medicine (CAM) Practices: Elucidating the Impact on Healthcare Systems, Mechanisms, and Paediatric Applications.

“…In some other countries, the increased prevalence of CAM not only may have impacts on the financial resources of a healthcare system, but it also has elicited changes in particular settings such as cancer: in Malaysia, where the prevalence of CAM users was approximately 46.5%, a multi-centre cross-sectional study reported that in patients with breast cancer, the use of CAM was associated with delays in presentation (OR 1.65; 95% CI: 1.05-2.59), diagnosis (OR 2.42; 95% CI: 1.56-3.77) and treatment of breast cancer (OR 1.74; 95% CI: 1.11-2.72) [24]. Similar results have been reported in the paediatric population; according to an Indonesian study in a cohort of oncologic paediatric patients, authors reported an association between CAM users and a delay in the diagnosis of solid tumours (OR = 1.86, 95% CI: 1.13-3.08, p = .015) with a median delay of 14 days [25].…”

The Epidemiological Study of Children with Malignant Disorders in the Pediatric Department at Menoufia University Hospital, Menoufia, Egypt during the Last Fifteen Years

“…Iran J Ped Hematol Oncol. 2024, Vol 14, No 1,[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited.…”

“…(1,2) Leukemia represents the most frequent pediatric malignancies (about 28%) followed by tumors of the central nervous system (CNS) (about 26%) followed by lymphoma (about 8%), less frequent neuroblastoma (8%), nephroblastoma (5%), malignant bone tumors (5%), soft tissue tumors (7%), germ-cell tumors (about 4%). (3)(4)(5)(6).…”

Contemporary Problems in Early Childhood Education (Case Study at the President Filia Gracia Foundation Puruk Cahu Kindergarten)

“…2) The current growth of PAUD If observed closely, the current condition of PAUD in Indonesia shows at least five new symptoms. First, the growing awareness of parents about the importance of children's golden ages (Golden Ages) so that they flock to enroll their children in PAUD institutions (Sari et al, 2023). This awareness is supported by educational policy policies that favor greater development of PAUD so that public awareness can be accommodated.…”