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: Tumor stage may relate to the chronology of neoplasm growth and has been used as an outcome variable when studying diagnostic delay in oral cancer. However, tumor growth rate may act as a confounding factor. We reviewed a total of 63 incident cases of oral cancer. The variables considered for the study included age, sex, smoking history, tumor site, TNM stage, Ki-67 score, and diagnostic delay. Significant differences between survivors and exitus were found in terms of tumor stage at diagnosis (I-II vs III-IV), sex, and Ki-67 scores. When the analysis was adjusted for tumor stage at diagnosis (I-II vs III-IV), proliferative activity resulted to be an independent prognostic factor for survival, whereas diagnostic delay did not influence survival. These results seem to suggest that survival from oral cancer is affected more by the biology of the cancer (rapid tumor growth) than by diagnostic delay.
    Head & Neck 10/2010; 32(10):1377-84. · 2.83 Impact Factor
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    ABSTRACT: BACKGROUND Cancers of the head and neck still are detected mostly at an advanced stage, especially pharyngeal cancers.METHODS To study the impact of patient and professional delay on survival, the authors collected the data from 84 patients with pharyngeal cancer. In addition to clinical data from the tertiary care center, the authors evaluated the data from the first medical visit in primary care before the diagnosis of malignancy had been made.RESULTSThe patients who had a patient delay of 2 months or more had a significantly higher relative hazard of death (HR; HR, 2.5; 95% confidence interval (CI), 1.39–4.38) compared with the patients with less than 2 months of patient delay. This risk was significant among the patients with oropharyngeal (P = 0.008) and nasopharyngeal cancer (P = 0.03), but not in those with hypopharyngeal cancer (P = 0.56). In contrast, there was no relation between professional diagnostic delay and prognosis. Advanced stage (International Union Against Cancer [UICC] TNM; Stage IV vs. Stage I–III; HR, 3.19; CI, 1.61–6.35) and age (≥ 65 vs. < 65 years; HR, 2.47; CI, 1.32–4.62) also were associated with an impaired prognosis.CONCLUSIONS Shortening of patient delay would substantially improve survival in pharyngeal cancer, but this goal seems difficult to attain because symptoms emerge late in pharyngeal cancer, and no specific symptoms or patient characteristics were related to a long patient delay. Professional delay does not have an impact on survival in pharyngeal cancer. Cancer 2001;92:2885–91. © 2001 American Cancer Society.
    Cancer 11/2001; 92(11):2885 - 2891. · 5.20 Impact Factor