Patient Delay in Cancer

Abstract Analysis was made of psychosocial factors influencing the amount of elapsed time between the first sign or symptom of cancer and the search for medical help in 563 patients. Delay remained much the same as that reported in similar surveys conducted at the same hospital 30 and 50 years earlier. Detection of cancer through routine physical examination ensured the least delay. Worry about the condition reduced delay time more than pain, incapacity or other factors. Patients of higher social class sought help significantly sooner than the less privileged. Those who openly referred to their condition as cancer had significantly less delay than those who used the term, "tumor," or some other euphemism. Delay in seeking medical help appeared to be a conscious and deliberate act rather than a failure to perceive the neoplasm or to comprehend its consequences. (N Engl J Med 289: 14–20, 1973)