Factors Affecting Cancer Diagnosis and Treatment Delays in Ukraine

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PURPOSE Prompt diagnosis is a key step in starting effective cancer treatment. The earlier the disease is detected, the more opportunities for successful treatment and improved prognosis. We explored perceived factors affecting cancer screening and treatment in Ukraine, which faced multiple challenges following Russia's invasion. METHODS Online surveys assessing cancer diagnosis and treatment delays in Ukraine were distributed to patients in Ukraine through cancer-focused social media in April 2023. For patients who reported experiencing delays in either diagnosis or treatment, the survey included open-ended questions inquiring about details of this and suggestions for improvement. Data was analyzed using thematic analysis and descriptive statistics. RESULTS Overall, 307 patients from all regions of Ukraine were surveyed. Out of them, 225 were women (73.29%), while men accounted for 26.71% of all cases. Breast cancer comprised 102 cases (33.22%), another type - 89 (29.10%), lymphoma 22 (7.17%), rectal cancer 17 (5.54%), head and neck cancer 15 (4.78%). Notably, 143 (46.59%) were diagnosed before the large-scale invasion, while the remaining 164 (53.42%) were diagnosed after. Of 307, 66 (21.5%) reported experiencing diagnostic delays. For these 66, primary reasons for delays included physician negligence for 17 (25.8%), expensive diagnostic tests 14 (21.2%), long waiting time for results 12 (18.2%), Russia's full-scale invasion for 8 (12,1%), incorrect initial diagnosis for 6 (9.1%), misinterpretation of test results for 4 (6.1%), difficulty organizing logistics from the initial visit to diagnosis 2 (3%), with incorrect sample collection, coronavirus infection, and physician refusing to provide treatment cited by 1 (1.5%) patient each. Of 307, 63 participants (20.5%) reported experiencing treatment delays. For the 53, reasons included the war situation for 13 (20.6%), high cost of treatment for 12 (19%), unavailability of prescribed medications for purchase in Ukraine for 12 (19%), suboptimal doctor-patient relationship for 9 (14.3%), long treatment waiting lists for 9 (14.3%), corruption cited by 5 (7.9%), and incomplete understanding of the treatment plan by the patients cited by 3 (4.8%). CONCLUSION Both diagnostic and treatment delays were fairly common among our respondents. Opportunities for improvement include strategies to enhance the doctor-patient relationship, improve affordability and accessibility of cancer therapy.

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