Determinants of Delayed Presentation of Patients with Primary Malignant Musculoskeletal Tumours Managed in a Tertiary Referral Hospital

Abstract

Background: Malignant musculoskeletal tumours are comparatively rare tumours and delays in diagnosis and treatment are common. Understanding the factors that influence delay is important so as to improve the outcomes for cancer patients. Aim: To describe factors associated with delay in presentation of patients with primary musculoskeletal tumours. Study Design: Descriptive cross-sectional study. Setting: The study was conducted in a tertiary referral hospital from July to December 2014. Methodology: 56 patients with a confirmed histopathological diagnosis of a primary malignant musculoskeletal tumour and who had consented to the study were included. Data was collected using a pre-tested questionnaire. The clinical findings, laboratory results and radiographs of the lesions and the chest, as well as histopathological results were used to stage the musculoskeletal tumour. Data was analyzed using SPSS software version 20.0. Univariate and bivariate analysis was done for associations and results presented in the form of tables, pie charts and bar graphs. Results: A total of 56 patients were studied, 34 (60.7%) males and 22 (39.3%) females with a male to female ratio of 1.5:1. 73.2% (41) of the patients were adults while children comprised 26.8% (15). The age range was 4yrs-78yrs, with a mean of 32.25yrs. The mean patient delay was four months with 50% (28) of the patients seeking care for the first time after three months. Males were twice as likely to present late compared to females (OR 2.5, P=0.10) while patients younger than 40 years were more likely to present late (OR 1.4, P=0.59). Low educational level (OR 3.7, P=0.15) and low family income (OR 2.3, P=0.38) were associated with delayed presentation. Conclusion: Delayed presentation of patients with MS tumours is influenced by a multitude of factors ranging from the socio-demographics (age, sex, education level), socio-economic status and tumour knowledge, beliefs and perception.