Delayed presentation and diagnosis of patients with primary malignant musculoskeletal tumours seen at Mulago Hospital

Abstract

Background: Malignant musculoskeletal tumours are comparatively rare tumours and delays in diagnosis and treatment are common. Several factors have been associated with delayed presentation of patients with tumours. These include socio-demographic factors like young age, male gender, marital status, education level; as well as socioeconomic factors like employment status, annual income and family health expenditure. Other factors cited include knowledge, practices and beliefs of the patients and communities, with regards to cancer. Presentation of these patients at Mulago hospital has been noted to be late however; the stage and factors associated with the delayed presentation have not been documented. Objective: The aim of this study was to describe the delayed presentation and diagnosis of patients with primary malignant musculoskeletal tumours seen at Mulago hospital. Methods: This was a hospital based descriptive cross-sectional study of 56 patients with primary malignant musculoskeletal tumours, who were recruited consecutively over a period of 6 months. Data was collected using a pre-tested questionnaire. The clinical findings, laboratory results, X-rays of the lesions and the chest, as well as histopathological results were used to stage the musculoskeletal tumour. This data was entered into Epi-data version 3.1 and analyzed using SPSS software version 20.0. The results were summarized in form of tables, pie charts and bar graphs. Univariate and bivariate analysis was done to identify the associations between the independent and dependent variables.

Results: The mean patient delay in this study was found to be four (4) months with 50% of the patients seeking care for the first time after three (3) months of symptom onset. This study also showed that majority of patients presented with advanced stage of disease. In the solid tumours group, 45.7% had stage III, 48.6% stage IIb, and 5.7% had stage IIa. No patient was seen with stage I disease. In the multiple myeloma group, 52.4% had stage III and 47.6% had stage II disease. No patient was seen with stage I disease. The male to female ratio was 1.5:1 (60.7% against 39.3%). The age range of the study participants was 4yrs-78yrs, with a mean age of 32.25yrs. The factors underlying delayed presentation and diagnosis included socio-demographics like younger age, male gender, low education level as well as low family income. Conclusion: Patients with primary malignant musculoskeletal tumours in our setting present late. This is influenced by a multitude of factors ranging from the socio-demographics, socio-economic status and tumour knowledge, beliefs and perception. ent are common. Several factors have been associated with delayed presentation of patients with tumours. These include socio-demographic factors like young age, male gender, marital status, education level; as well as socioeconomic factors like employment status, annual income and family health expenditure. Other factors cited include knowledge, practices and beliefs of the patients and communities, with regards to cancer. Presentation of these patients at Mulago hospital has been noted to be late however; the stage and factors associated with the delayed presentation have not been documented. Objective: The aim of this study was to describe the delayed presentation and diagnosis of patients with primary malignant musculoskeletal tumours seen at Mulago hospital. Methods: This was a hospital based descriptive cross-sectional study of 56 patients with primary malignant musculoskeletal tumours, who were recruited consecutively over a period of 6 months. Data was collected using a pre-tested questionnaire. The clinical findings, laboratory results, X-rays of the lesions and the chest, as well as histopathological results were used to stage the musculoskeletal tumour. This data was entered into Epi-data version 3.1 and analyzed using SPSS software version 20.0. The results were summarized in form of tables, pie charts and bar graphs. Univariate and bivariate analysis was done to identify the associations between the independent and dependent variables.

Results: The mean patient delay in this study was found to be four (4) months with 50% of the patients seeking care for the first time after three (3) months of symptom onset. This study also showed that majority of patients presented with advanced stage of disease. In the solid tumours group, 45.7% had stage III, 48.6% stage IIb, and 5.7% had stage IIa. No patient was seen with stage I disease. In the multiple myeloma group, 52.4% had stage III and 47.6% had stage II disease. No patient was seen with stage I disease. The male to female ratio was 1.5:1 (60.7% against 39.3%). The age range of the study participants was 4yrs-78yrs, with a mean age of 32.25yrs. The factors underlying delayed presentation and diagnosis included socio-demographics like younger age, male gender, low education level as well as low family income. Conclusion: Patients with primary malignant musculoskeletal tumours in our setting present late. This is influenced by a multitude of factors ranging from the socio-demographics, socio-economic status and tumour knowledge, beliefs and perception.