How long it takes to diagnose and start treating cancer in high and lower income countries

What is it about?

Cancer is a leading cause of death globally and timely diagnosis and treatment are considered essential for improving cancer outcomes. Three main intervals describe the time patients spend in the pathway to treatment of cancer: the patient interval (from symptom start to first presentation to a healthcare professional), the diagnostic interval (from first presentation to diagnosis), and the treatment interval (from diagnosis to the start of treatment). The duration of these intervals could vary greatly depending on the type of cancer and the socio-economic level of the country. We conducted a systematic review with meta-analysis of the duration of the patient, diagnostic, and treatment intervals in adult patients with diverse types of cancer. We included 410 articles representing 68 countries and reporting on 5,537,594 patients; the majority of articles reported data from high-income countries (72%), with only 28% reporting data from lower-income countries. Patient intervals in studies from lower-income countries were consistently 1.5 to 4 times longer that patient intervals from studies from high-income countries for almost all cancer sites. The majority of data on the diagnostic and treatment intervals came from high-income countries and there was large variation according to the type of cancer.

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Photo by National Cancer Institute on Unsplash

Photo by National Cancer Institute on Unsplash

Why is it important?

These results identify the cancers where diagnosis and treatment initiation may take the longest and reveal important global disparities in early diagnosis and treatment. Efforts should be made to reduce help-seeking times for cancer symptoms in lower-income countries and conduct more research in lower-income contexts, especially on the intervals to diagnosis and treatment.