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Open Access Debate

Patient delay in cancer studies: a discussion of methods and measures

Rikke Sand Andersen12*, Peter Vedsted12, Frede Olesen12, Flemming Bro12 and Jens Søndergaard123

Author Affiliations

1 The Research Unit for General Practice, Institute of Public Health, University of Aarhus, Bartholins Allé 2, DK-8000 Aarhus C, Denmark

2 Department of Family Medicine, Institute of Public Health, University of Aarhus, Bartholins Allé 2, DK-8000 Aarhus C, Denmark

3 The Research Unit for Family Medicine, Institute of Health Services Research, University of Southern Denmark, JB Windsløws Vej 9A, DK-5000 Odense C, Denmark

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BMC Health Services Research 2009, 9:189  doi:10.1186/1472-6963-9-189

Published: 19 October 2009

Abstract

Background

There is no validated way of measuring the prevalence and duration of patient delay, and we do not know how people perceive and define the time intervals they are asked to report in patient delay studies. This lack of a validated measure hampers research in patient delay and is counterproductive to efforts directed at securing early diagnosis of cancer.

Discussion

The main argument of the present paper is that current studies on patient delay do not sufficiently consider existing theories on symptom interpretation. It is illustrated that the interpretation of bodily sensations as symptoms related to a specific cancer diagnosis is embedded within a social and cultural context. We therefore cannot assume that respondents define delay periods in identical ways.

Summary

In order to improve the validity of patient delay studies, it is suggested that research be strengthened on three counts: More research should be devoted to symptom interpretation processes, more research should seek to operationalise patient delay, and, importantly, more research is needed to develop valid instruments for measuring patient delay.