article · BMC Research Notes
This study investigated delays in diagnosing and treating primary bone sarcoma at a tertiary referral centre in Ethiopia. Researchers analysed data from 212 patients between 2021 and 2025, focusing on patient delay, diagnostic delay, and time to treatment initiation (TTI). The findings revealed significant delays, with a median total symptom interval of 161 days. Patient delay, from symptom onset to first healthcare contact, was the largest component at three months. Most patients presented with advanced disease. Factors independently associated with longer TTI included being over 40 years old and having a farming occupation, while lower extremity tumour location was linked to shorter TTI. The study highlights the urgent need for earlier diagnosis and better access to specialised sarcoma care in resource-limited regions.
Timely diagnosis and treatment are crucial for improving outcomes for patients with primary bone sarcoma. Understanding the specific delays and contributing factors, especially in low-resource settings, can help healthcare systems develop targeted interventions to reduce these delays, leading to earlier treatment and potentially better survival rates for affected individuals.
The abstract does not indicate a direct application pathway for a product or service. However, the findings could inform the development of public health campaigns or healthcare system interventions aimed at reducing diagnostic and treatment delays for bone sarcoma in low-resource settings. This is early-stage research providing insights for policy and programme development rather than a commercial product.
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Timely diagnosis and treatment of primary bone sarcoma are important determinants of patient outcomes. However, substantial delays remain a major challenge in low-resource settings. Previous studies have associated prolonged diagnostic delays with adverse oncologic outcomes, including advanced-stage and metastatic disease at presentation. This study aimed to characterize delay patterns and factors associated with time to treatment initiation (TTI) among patients with primary bone sarcoma treated at a tertiary referral center in Ethiopia. A retrospective cohort study was conducted among 212 patients with histologically confirmed primary bone sarcoma treated between January 2021 and January 2025. Patient delay (symptom onset to first healthcare contact), diagnostic delay (first healthcare contact to histopathological diagnosis), and TTI (histopathological diagnosis to initiation of definitive treatment) were assessed. Delay intervals were summarized using medians and interquartile ranges (IQR). Bivariate comparisons were performed using the Mann–Whitney U and Kruskal–Wallis tests, and factors independently associated with TTI were evaluated using multivariable gamma regression. The median patient delay was 3 months (IQR: 2–5 months), diagnostic delay was 35 days (IQR: 26–45 days), TTI was 23 days (IQR: 18–27 days), and the median total symptom interval was 161 days (IQR: 126–220 days). Most patients presented with Enneking stage IIB disease (67.5%). In multivariable analysis, patients older than 40 years experienced an expected 22% longer TTI than younger patients, while farming occupation was associated with an expected 9% longer TTI. Lower extremity tumor location was associated with an expected 7% shorter TTI. Patients with primary bone sarcoma experienced substantial delays throughout the diagnostic and treatment pathway, with patient delay representing the largest component of overall delay. Older age and farming occupation were independently associated with prolonged TTI. These findings highlight the need for earlier diagnosis and improved access to specialized sarcoma care in resource-limited settings.
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DOI: 10.1186/s13104-026-07992-3
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