Effect of Treatment delay of cervical cancer on quality of life of patients at the Uganda Cancer Institute

Abstract

Introduction: The burden of cervical cancer represents a major growing public health concern globally with an estimated age-standardized incidence of 56.2 cases per 100000 women years and a mortality rate of 7.2 deaths per 100000 women years. Cervical cancer is a preventable disease with early diagnosis and treatment having shown to improve survival rate, and quality of life and reduces mortality and morbidity. However, there is little information regarding the time interval between diagnosis and treatment initiation of cervical cancer patients in Uganda and how treatment delays can influence patient quality of life. This study aimed to evaluate the effect of delays in cervical cancer treatment initiation on patient quality of life among Ugandan women. Methodology: This was a cross-sectional study conducted among 456 women initiated on any form of cervical cancer treatment at the Uganda cancer institute (UCI). Data on the quality of life was collected using the Functional Assessment of Cancer Therapy with Cervical Cancer Subscale (FACT- Cx) questionnaire and analyzed using STATA version 16. To examine the effect of treatment delay on the quality of life of study participants, a chi-square test was done. Adjustment for potential confounding variables was done using logistic regression analysis. A P-Value <0.05 was considered statistically significant. Results. The average time from cervical cancer diagnosis to treatment initiation was 98.73 days (IQR 40-102), with only 53.1% starting within the recommended 60 days. Timely treatment initiation was significantly associated with religion (P=0.026), employment status (P=0.006), distance to health facilities (P=0.036), and cancer differentiation state (P=0.006). Participants' overall quality of life (QoL) score was 57.14 (SD 0.6), indicating moderate well-being. Only 9.4% reported good QoL, while 30.5% had poor QoL. No significant relationship was found between treatment delays and QoL (P=0.731). Conclusion: Cervical cancer patients in Uganda demonstrated substantial delays to initiate cervical cancer treatment after diagnosis, although this has no significant effect on their quality of life. There is need to develop clear and efficient treatment pathways to minimize delays in treatment initiation but also focus on other factors, such as psychological support, symptom management, and social support to enhance patient quality of life.