Delay in the diagnosis of oral squamous cell carcinoma.
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.
- SourceAvailable from: Camile Farah[Show abstract] [Hide abstract]
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.Journal of Cancer Policy 03/2013; 1(s 1–2):e2–e7.
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ABSTRACT: Objectives: To investigate the approach of both pharmacies and herbalists' shops while offering a proper advice for patients seeking guidance on a potentially malignant oral lesion. Materials and Methods: A cross-sectional, descriptive study was undertaken using the standardized patient approach on a representative sample of pharmacies and herbalists' shops in Bhopal city. The study sample was selected by stratified random sampling technique and was contacted by telephone. Our patient's introductory statement was, "I have a painful ulceration on the tongue since 3 months. What would you advise?" To avoid the hypothetical bias in telephone answers, another study was designed for two regions of the city, of which pharmacies were visited in one and herbal shops in the other one. Results: A total of 497 establishments were contacted. Out of these, 368 were pharmacies (74.1%) and 129 were herbalists' shops (25.9%). Patients with potentially malignant lesions were more frequently referred to a dentist (16.03%) or a physician (23.36%) by the pharmacies compared to the herbalists' shops. In contrast, most of the herbalists' shops prescribed over-the counter (OTC) remedies (66.66%) and showed no interest in referring the patient to a dentist or a physician. Conclusion: Apart from pharmacists, the new probable off-clinical counselors (herbalists and pharmacy assistants) have been identified as potential factors of patient diagnostic delay in oral cancer. Educational strategies to improve advice and referral for these identified groups should be designed.Journal of cancer research and therapeutics. 07/2014; 10(3):618-622.
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ABSTRACT: BACKGROUND: The buccal cancer incidence in Brazil is one of the highest in the world. OBJECTIVES: To evaluate profile, risk factors and survival in patients with oral squamous cell carcinoma between 1982 and 2002 in a Brazilian population. MATERIAL AND METHOD: Age, gender, tumor site, previous clinical history, tobacco and alcohol consumption, actinic exposure, trauma by dental prosthesis, recurrences, metastases and survival rates were obtained from the medical files. RESULTS: From 340 patients, 84.4% were men and 15.6%, women (5.4:1). The lingual lesions were the most frequent ones (27.9%). Twenty percent of the patients reported trauma by dental prosthesis and in 73.8% of the lesions in lower lip an unprotected actinic exposure was reported. There was no difference between anatomical region and tobacco consumption concerning recurrences and regional or distant metastases. The average time of previous clinical history was 13 months, with significant differences among the anatomical regions. The 5-year-old survival rates were 24%. The survival rate of patients with recurrences and/or metastases varied according to age (< 60 or > 60), but not to previous medical history or anatomical regions. The man/woman discrepancy found was high, but decreased according to the rise of age. Tobacco and alcohol consumption is elevated in this population, but did not influence recurrences and metastases. The time of evolution of the lesions was long until the search for medical service. CONCLUSIONS: The low survival rates reflect the need of a more careful attention to buccal cancer in this population.Jornal Brasileiro de Patologia e Medicina Laboratorial 10/2006; 42(5):385-392.