A Hospital-Based Survey Assessing the Health Facility-Level Factors that Contribute to Delayed Diagnosis of Cervical Cancer; Patients Views

Abstract Background In Kenya, Cervical Cancer is the 2nd commonly diagnosed type of cancer and the top cause of cancer-related deaths among women. Globally, over 50% of Cervical Cancer diagnoses are made late, with this proportion rising to 80% in developing countries. Poor Health systems can cause delays in diagnosis, thus, this study focused to determine the health facility level factors that contribute to delayed diagnosis among Cervical Cancer patients at the Kenyatta National Hospital (KNH). Methods An analytical cross-sectional mixed method study was adopted to collect data on hospital and referral experiences from 139 Cervical Cancer patients systematically sampled at KNH, using a semi-structured questionnaire. Associations between stage at diagnosis and hospital and referral experiences were tested using logistic regression model at 95% Confidence Interval. Results 86 (61.9%) were diagnosed at advanced stages III and IV. The risk factors for delayed diagnosis were; more number of referral times (p-value = 0.000), availability of referral challenges (p-value = 0.041), Prolonged diagnosis appointments (p-value = 0.059) and long waiting periods for diagnosis results, (p-value = 0.007), in the bivariate model. Only More number of referral times was significantly associated with delayed diagnosis in the multivariate model (p-value = 0.001). Referral challenges included, misdiagnosis, cost of diagnosis and prolonged diagnosis appointments. Conclusion Advanced stage at presentation for most patients due to poor health and referral systems inadequate medical personnel and diagnosis equipment. Improve referral systems and encourage Public Private Partnerships (PPPs) to decentralize diagnostic centers and equipment and train more expertise on Cervical Cancer