Barriers to Seeking Treatment Among Esophageal Cancer Patients in North East India: A Cross-Sectional Study

Background Esophageal Cancer(EC), despite the obvious symptoms, commonly presents as locally advanced disease in India. Identification of the barriers at the individual, family, community and health system levels is extremely important for improvement of healthcare delivery. This study was performed to study the factors which lead to the delay in presentation of EC and to identify barriers at various levels. Methods A prospective, cross-sectional study approved by the Institutional Ethics Committee was performed in a public sector tertiary hospital of a region with the highest incidence of EC in India. A questionnaire, developed and validated for content, was administered to consenting patients, after the treatment plan was finalized by the Multidisciplinary Team. Descriptive statistics were used. Results Of the 110 patients(median age-53 years), 104 (94.5%) presented with dysphagia. Majority of the patients (56.4%) consulted a healthcare professional within a week of developing symptoms. The reason for delay in others was because they did not think it would be cancer (88.1%). The time for appointment with an oncologist was <3 days in 82 (74.5%) and 88.2% underwent Esophagogastroscopy within a week. The duration between pathological confirmation of the diagnosis and finalization of the treatment plan was a week in most (47.3%) of the patients, with the actual treatment being started within a week in 28(25.5%) patients. Conclusion Improving awareness regarding the symptoms of EC in regions with high incidence may enable early detection and treatment.