Factors associated with diagnostic delay in non-melanoma skin cancer in early clinical care settings

Abstract

Non-melanoma skin cancer represents the most prevalent group of malignant neoplasms worldwide and constitutes a significant public health concern due to its high incidence and the clinical, functional and economic consequences associated with delayed diagnosis. Although basal cell carcinoma and squamous cell carcinoma generally exhibit low metastatic potential in their early stages, delays in clinical identification favour tumour progression, local tissue infiltration and the need for more complex treatments, with a negative impact on quality of life. In early clinical care settings, timely diagnosis is influenced by a complex interaction of individual, clinical and structural factors, including low risk perception, absence of alarming symptoms, morphological heterogeneity of lesions and their resemblance to benign dermatoses, as well as limitations in dermatological training and access to specialised care. The aim of this study is to systematically analyse the available scientific evidence on the factors associated with diagnostic delay in non-melanoma skin cancer in primary and ambulatory care contexts. To this end, a descriptive–analytical systematic review was conducted, based on a rigorous documentary analysis of the scientific literature and guided by the PRISMA 2020 statement. The synthesis of findings allowed the identification of recurring patterns, conceptual convergences and relevant knowledge gaps, providing elements to strengthen early detection strategies and clinical decision-making in initial levels of care.