Socio-Demographic Factors and Delays in Diagnosis of Cervical Cancer Among Women
Main Article Content
Abstract
Background: Cervical cancer remains a significant public health concern, particularly in low- and middle-income regions where delayed diagnosis contributes to increased morbidity and mortality. Despite the availability of effective screening methods, many women continue to present at advanced stages due to socio-demographic and behavioral barriers. Objective: To assess the socio-demographic factors associated with delays in the diagnosis of cervical cancer and to evaluate health-seeking behavior and screening history among affected women. Methods: A cross-sectional study was conducted over four months in Central Punjab, involving 72 women aged 25–65 years with recently diagnosed cervical cancer. Data were collected through structured interviews and medical record review, focusing on socio-demographic characteristics, health-seeking behavior, and prior screening history. Diagnostic delay was defined as more than three months between symptom onset and confirmed diagnosis. Statistical analysis included independent t-tests, ANOVA, Pearson correlation, and chi-square tests using SPSS version 25. Results: The mean diagnostic delay was 4.7 ± 2.1 months, with 61.1% of participants experiencing delays beyond three months. Lower education, rural residence, and low income were significantly associated with prolonged delay (p<0.05). Only 18.1% of participants had a history of cervical cancer screening, and absence of screening was strongly linked to delayed diagnosis (p=0.001). A moderate positive correlation was observed between age and delay duration (r=0.41, p=0.002). Initial consultation with non-specialized providers further contributed to extended diagnostic timelines. Conclusion: Socio-demographic disparities, poor screening uptake, and delayed health-seeking behavior significantly contributed to late diagnosis of cervical cancer. Targeted interventions focusing on awareness, accessibility, and strengthening of primary healthcare services are essential to promote early detection and improve outcomes.
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Nnaji CA, Ezenwankwo EF, Kuodi P, Walter FM, Moodley JJBo. Timeliness of diagnosis of breast and cervical cancers and associated factors in low-income and middle-income countries: a scoping review. 2022;12(2):e057685.
2. Allahqoli L, Dehdari T, Rahmani A, Fallahi A, Gharacheh M, Hajinasab N, et al. Delayed cervical cancer diagnosis: a systematic review. 2022;26(22):8467-80.
3. Nnaji CA, Kuodi P, Walter FM, Moodley JJBo. Effectiveness of interventions for improving timely diagnosis of breast and cervical cancers in low-income and middle-income countries: a systematic review. 2022;12(4):e054501.
4. Desta GM. Determinants of Delay in Seeking Care among women presenting with Advanced-stage cervical cancer in northwest Ethiopia, a mixed-methods study. 2026.
5. Tarannum N, Binte Ismail Eva IA. A review on the socio-demographic and cultural factors associated with the delayed diagnosis of cervical cancer and possible interventions in screening attitude: From South Asian perspective: Brac University; 2022.
6. Lacika JL, Wabinga H, Kagaayi J, Opito R, Orach CG, Mwaka ADJBWsH. Diagnostic and pre-treatment intervals among patients with cervical cancer attending care at the Uganda Cancer Institute: a cross-sectional study. 2023;23(1):633.
7. Tekalign T, Teshome MJPo. Prevalence and determinants of late-stage presentation among cervical cancer patients, a systematic review and meta-analysis. 2022;17(4):e0267571.
8. Ton M. Cancer detection to treatment: Health disparities and factors that contribute to them: University of Washington; 2024.
9. Moodley J, Scott SE, Day S, Guzha BT, Chirenje ZM, Ataguba JE, et al. Time to diagnosis for breast, cervical and colorectal cancer in Zimbabwe and South Africa: a cross-sectional study. 2026;11(2):e021889.
10. Kuriakose S, Krishnamurthy A, Vinutha R, Ramshankar V, Sekhar S, Walia GK, et al. Time intervals and patient-level factors in oral cancer diagnostic pathways: An application of the WHO framework in India. 2022;81:102283.
11. Ojha N, Jha M, Shrestha E, Dangal GJJJotNMA. Late stage cervical cancer among confirmed cervical cancer cases in a tertiary care centre: a descriptive cross-sectional study. 2021;59(239):630.
12. Liang J, Mvemba A, Swanson M, Hsu I-CJ, Alvarez E, Chapman J, et al. Delay to timely treatment in locally advanced cervical cancer: insurance inequities in access to gynecologic oncology. 2025.
13. Gozum S, Nimri OF, Merzah MA, Vitorino RJD. Cancer Screening and Prevention in MENA and Mediterranean Populations: A Multi-Level Analysis of Barriers, Knowledge Gaps, and Interventions Across Indigenous and Diaspora Communities. 2025;14(1):10.
14. Afaya A, Ramazanu S, Bolarinwa OA, Yakong VN, Afaya RA, Aboagye RG, et al. Health system barriers influencing timely breast cancer diagnosis and treatment among women in low and middle-income Asian countries: evidence from a mixed-methods systematic review. 2022;22(1):1601.
15. Dereje N, Addissie A, Worku A, Assefa M, Gebremariam A, Kantelhardt EJ, et al. Barriers to early diagnosis and treatment of cervical cancer in Addis Ababa, Ethiopia: qualitative study. 2025;15(1):e087792.
16. Shimels T, Gashawbeza B, Gedif Fenta TJFiO. Access to advanced healthcare services and its associated factors among patients with cervical cancer in Addis Ababa, Ethiopia. 2024;14:1342236.
17. Kasper G, Momen M, Sorice KA, Mayhand KN, Handorf EA, Gonzalez ET, et al. Effect of neighborhood and individual-level socioeconomic factors on breast cancer screening adherence in a multi-ethnic study. 2024;24(1):63.
18. Allard NC. Identifying Opportunities to Promote Young Adult Healthcare Seeking and Improve the Timeliness and Severity of Cancer Diagnoses: An Examination of Symptom Appraisal, Help-Seeking Decisions, and Psychosocial and Behavioral Barriers to Healthcare Engagement: State University of New York at Buffalo; 2025.
19. Aroh AC, Madujibeya I, Antwi HA, Aroh U, Pine M, Adegboyega AJCN. Examining the Role of Social Determinants of Health on Adherence to Pap Screening Guidelines for US Women Aged 21 to 64 Years: Evidence From the 2022 Health Information National Trends Survey. 2024:10.1097.
20. Endalamaw A, Alganeh H, Azage M, Atnafu A, Erku D, Wolka E, et al. Improving cervical cancer continuum of care towards elimination in Ethiopia: a scoping review. 2024;35(3):549-59.
21. Scott EC, Hoskin PJJE. Health inequalities in cancer care: a literature review of pathways to diagnosis in the United Kingdom. 2024;76.
22. Wassie LA, Mekonnen CK, Tiruneh YM, Melkam M, Belachew EA, Zegeye AFJBc. Advanced-stage presentation of cancer at the time of diagnosis and its associated factors among adult cancer patients at Northwest Amhara comprehensive specialized hospitals, Northwest Ethiopia 2022. 2024;24(1):68.
23. Damsees R, Jaghbir M, Salam M, Al-Omari A, Al-Rawashdeh NJBo. Unravelling the predictors of late cancer presentation and diagnosis in Jordan: A cross-sectional study of patients with lung and colorectal cancers. 2023;13(5):e069529.
24. Oringtho S, Mwaka AD, Garimoi Orach C, Wabinga HJAoM. Awareness of cervical cancer risk factors and preventive approaches, and perceived causes of cervical cancer among secondary school girls: a cross-sectional study in Northern Uganda. 2024;56(1):2374860.
25. Kiros M, Mesfin Belay D, Getu S, Hailemichael W, Esmael A, Andualem H, et al. Prevalence and determinants of pre-cancerous cervical lesion and human papillomavirus among HIV-infected and HIV-uninfected women in North-West Ethiopia: a comparative retrospective cross-sectional study. 2021:719-25.
26. Saki S, Ali NR, Saki SS, AlRabeea ZS, AlRemeithi FN, Carrick FR, et al. Barriers to healthcare seeking, beliefs about ovarian cancer and the role of socio-economic position. A cross-sectional multilevel study in Dubai, a multicultural society. 2021;10(3):jphr. 2021.73.