A Study on the Extent of Delays in Seeking Medical Care Among Gastric Cancer Patients and Its Associated Factors

Abstract

Objective: To investigate the extent of delayed medical care among gastric cancer patients and analyze the associated factors, thereby providing a basis for the early identification of high-risk populations, the implementation of stratified interventions, and the optimization of care pathways. Methods: Using convenience sampling, 427 gastric cancer patients were selected from the Shaanxi Provincial Cancer Hospital and the Shaanxi Provincial Early Diagnosis and Treatment Program for Upper Gastrointestinal Tract Cancers between January and April 2026. Data were collected using a demographic questionnaire, the abbreviated version of the Disease Perception Questionnaire, the Cancer Patient-Reported Outcomes Economic Toxicity Scale, and the Social Support Rating Scale. Delay in seeking medical care was categorized as mild (2-4 weeks), moderate (5-11 weeks), or severe (≥12 weeks) based on the time interval from the onset of symptoms to the first medical visit. Ordinal multinomial logistic regression analysis was used to identify factors associated with the degree of delay. Results: Among the 427 patients, 162 (37.9%) experienced mild delay, 145 (34.0%) experienced moderate delay, and 120 (28.1%) experienced severe delay. Ordered multinomial logistic regression analysis revealed a significant socioeconomic gradient in the degree of delay: increasing age (OR=1.042), higher total disease perception scores (OR =1.070), an education level of elementary school or below (OR = 5.680) or junior high school (OR=5.339), lower per capita monthly household income, participation in public cancer screening programs, and attributing the delay to “mistaking it for gastritis” or “concerns about costs” were associated with more severe delays (P < 0.05); Higher total social support scores (OR = 0.922), lower financial toxicity (higher COST scores, OR = 0.916), residence in the central urban area (OR=0.318), and a history of regular health checkups were associated with milder delays (P < 0.05). Conclusion: Delays in seeking medical care among gastric cancer patients are generally significant and exhibit a socioeconomic gradient characterized by advanced age, low educational attainment, low income, and residence in rural districts or counties. These delays result from the combined effects of symptom attribution, financial burden, social support, and access to services. Nursing care should focus on implementing stratified, targeted interventions for the aforementioned high-risk populations, strengthen the identification of symptom attribution and support for healthcare decision-making, promote financial relief, social support, and improved access to services, and refine the closed-loop system for post-screening referral and follow-up to facilitate early diagnosis and treatment.