The journey of cancer patients and the quest to equity: findings from Morocco

In a new article, scientists from the International Agency for Research on Cancer (IARC) and clinicians from four oncology centres in Morocco report that the time interval to confirm a diagnosis of cancer for patients in Morocco was, on average, almost twice as long as recommended by the World Health Organization (WHO) and several high-income countries. The results were published in the journal Public Health.

The researchers recruited more than 800 patients with cancer from four major oncology centres in Morocco and recorded the duration of different steps along the health-care pathway: the time intervals between the recognition of symptoms by patients, their first medical consultation, referral to biopsy and sampling, diagnosis of cancer, and initiation of treatment. These events are collectively defined as the patient’s journey to treatment. The study also collected sociodemographic information, medical information, and information relating to access to the oncology centre, patients’ beliefs, and patients’ opinions about the attitudes of medical staff.

Delays in cancer diagnosis and initiation of treatment are known to be associated with a worse survival outcome and an increased risk of mortality. The authors found that the interval from the recognition of symptoms to the initial health-care assessment had a median duration of 30 days. The diagnosis interval – the time between the first medical consultation and diagnosis – had a median duration of 52 days, which was almost twice as long as the timeframes recommended by Australia, the United Kingdom, and WHO, which all recommend less than 28 days. The treatment interval – the time between diagnosis of cancer and initiation of treatment – had a median duration of 28 days, which is within current international recommendations.

A limited number of countries have defined standards for the durations of the diagnosis and treatment intervals. Establishing target times for referral of patients with suspected cancer or after an abnormal screening test result is essential. Health systems should define and regularly monitor interval targets through quantitative data in order to be more equitable and more effective and to ensure that patients with cancer are treated within a defined timeframe.

Sauvaget C, Boutayeb S, Bendahhou K, Selmouni F, Belbaraka R, Muwonge R, et al.
The journey of cancer patients and the quest to equity: findings from Morocco.
Public Health, Published online 17 August 2023;
https://doi.org/10.1016/j.puhe.2023.07.015