# Diagnostic Delays and Economic Burden in Japanese Women with Endometriosis: A Cross-Sectional Analysis

## TL;DR

This study finds that delays in diagnosing endometriosis in Japanese women are linked to worse outcomes and higher use of self-treatment.

## Contribution

The study identifies a 1.5-year diagnostic delay as a critical threshold associated with disease progression and increased OTC pain medication use.

## Key findings

- A median diagnostic delay of 1.5 years was observed, with significant differences between short and long delay groups.
- Longer delays were associated with higher use of OTC pain medication and more advanced endometriosis stages.
- Early intervention strategies are suggested to reduce disease burden and promote timely healthcare-seeking behavior.

## Abstract

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: diagnostic delays longer than 1.5 years may contribute to disease progression and reliance on self-management, potentially postponing medical consultation. Early intervention strategies, including screenings and public awareness, may promote timely healthcare-seeking behavior. Future studies should prioritize clinical assessments and early diagnosis to reduce the burden of advanced disease.