Diagnostic Delays and Economic Burden in Japanese Women with Endometriosis

Background

This study investigates the association between diagnostic delay (DD) and clinical and behavioral variables among Japanese women with endometriosis, and explores an optimal cut-off point distinguishing short and long DD.

Methods

A cross-sectional online survey was conducted among 220 Japanese women aged 18–49 diagnosed with endometriosis. Data on healthcare behaviors, economic expenditures, and disease-specific outcomes were analyzed by stratifying participants based on DD length. Multivariate logistic regression models were applied.

Results

The mean age at initial symptom onset was 24.3 years, and at diagnosis, 27.7 years. The median DD was 1.5 years, with significant differences between short and long DD groups (P < 0.001). Longer DD was significantly associated with greater use of over-the-counter (OTC) pain medication (P = 0.008) and a higher proportion of Stage IV endometriosis (P = 0.022).

Conclusions

These findings indicate that diagnostic delays exceeding 1.5 years are associated with significant disease progression, and the use of over-the-counter pain medication whose healthcare behavior may contribute to the postponement of professional medical consultation. Early intervention strategies, such as routine screenings and awareness programs, could help patients seek medical attention earlier and potentially reduce the burden of advanced disease. Future research should use longitudinal designs with larger samples to better understand the healthcare behaviors of endometriosis patients in order to reduce burden of disease progression and guide equitable healthcare policies.

Key messages

• Diagnostic delays beyond 1.5 years in endometriosis are linked to disease progression and increased reliance on self-management among Japanese women.

• Reducing diagnostic delay through early intervention and awareness may improve timely care and reduce the burden of advanced endometriosis.