Delay in the diagnosis of oral squamous cell carcinoma.

Department of Otolaryngology, Aarhus University Hospital, Denmark.
Clinical Otolaryngology (Impact Factor: 2.39). 03/1995; 20(1):21-5. DOI: 10.1111/j.1365-2273.1995.tb00006.x
Source: PubMed

ABSTRACT Delay in diagnosis was recorded prospectively in 167 patients with an oral squamous cell carcinoma. The median total delay was 4 months of which two-thirds was patient delay. The corrected survival did not correlate with the total delay. The patient delay was not significantly correlated with tumour or patient factors and the unreliable nature of patient delay information makes such data clinically unusable. In contrast, the professional delay correlated significantly with some of these factors. The delay was longer for women than for men and the older the patient, the longer the delay. The professional delay was longest in patients with small tumours. Thus, registration of the professional delay provides information to be used to improve the diagnostic efficiency of the health care system.

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    ABSTRACT: Aim To discuss the broad evidence base on which strategies to enhance the early detection and diagnosis of oral cancer and potentially malignant disorders (PMD) should be designed. Methods We reviewed the evidence for current oral mucosal screening approaches and used a theoretical model to explore behavioural influences on the early detection of oral cancer, and to outline strategies for future interventions and research. Results While considerable advances are being made in techniques to detect oral cancer, there has been less attention paid to the patient and health care provider factors which may influence delays in detection of oral cancer. This review proposes that unless future theory based studies target these aspects of oral cancer, then efforts to improve its timely detection will have limited effectiveness. Conclusions A primary tenet of screening programs, whether opportunistic, targeted or population based is that at-risk people present for screening. They must also present early enough in the disease process for detection to lead to a better outcome. This is particularly relevant for oral cancer. Five-year survival rates have not improved over past decades and this has mainly been attributed to delays in detection. Early detection, diagnosis and treatment significantly enhance survival rates and reduce morbidity.
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