Factors influencing the time to presentation, diagnosis, and treatment of patients with esophageal cancer at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Esophageal Cancer (EC) is a malignancy with high incidence and mortality globally. Late presentation and diagnosis lead to poor outcomes and high cost of treatment. The aim of this study was to describe factors influencing the time to presentation, diagnosis and treatment of patients with esophageal cancer at Moi Teaching and Referral Hospital (MTRH). This was a cross-sectional study conducted on patients with esophageal cancer seeking treatment at MTRH during the study period. Consecutive sampling of the patients in oncology clinic and surgical wards was done until a sample size of 104 was achieved. Logistic regression was used to determine the associations between factors and timelines for presentation, diagnosis and treatment using R-4.1.0-win software. The association was measured using Odds Ratios (ORs) with 95% CI. Monthly income of < 20,000 Kenya shillings (OR=0.1, CI, 0.002-0.52) was associated with late presentation to the health facility after the onset of symptoms. Being widowed (OR 0.05, CI, 0.003-0.39) was associated with late diagnosis while referral from another facility to MTRH was associated with early diagnosis (OR=3.74 CI, 1.08- 14.7). Participants who had no medical insurance were more likely to be diagnosed and treated late (OR =0.3 CI, 0.079-0.82) and (OR= 0.27, CI, 0.079-0.82) respectively. Low income status was associated with late presentation to a health facility. Being widowed and lack of medical insurance were associated with late diagnosis and treatment while referral to MTRH was associated with early diagnosis.