Exploring the Reasons for Delay in Treatment of Oral Cancer

Department of Oral and Maxillofacial Surgery, University of California, San Francisco, San Francisco, Calif. 94143-0440, USA.
Journal of the American Dental Association (1939) (Impact Factor: 2.01). 11/2008; 139(10):1346-52. DOI: 10.14219/jada.archive.2008.0046
Source: PubMed


Oral cancer continues to be diagnosed and treated at a late stage, which has a negative effect on outcomes. This study identified and quantified delays in diagnosis and treatment.
The authors conducted a study that included all new patients seen in the Department of Oral and Maxillofacial Surgery, University of California, San Francisco, between 2003 and 2007 who had a diagnosis of squamous cell carcinoma of the oral cavity. They identified the time intervals for six stages, beginning with the time at which patients first became aware of symptoms and ending with the time at which definitive treatment began.
The total time from patients' first sign or symptoms to commencement of treatment was a mean of 205.9 days (range, 52-786 days). The longest delay was from the time symptoms first appeared to the initial visit to a health care professional (mean time, 104.7 days; range, 0-730 days).
Health care professionals need to place greater emphasis on patient education to encourage early self-referrals.
Patients should be encouraged to visit a health care professional when signs or symptoms of oral cancer first develop.

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    • "Squamous cell carcinomas of the oral cavity are common malignancies. The low survival rates and morbidity can be attributed to the late diagnosis [3]. Hence, several new trends have been emerging that have successfully addressed this problem among which salivary RNAs are noteworthy [4]. "
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    ABSTRACT: Oral squamous cell carcinomas (OSCC) are common malignancies that affect almost a million people every year. The key issue in reducing mortality and morbidity associated with OSCC is to develop novel strategies to identify OSCC at an early stage. One such strategy is the identification of biomarkers. So far, more than 100 biomarkers are recognized in the detection of oral cancer and they range from proteins to nucleic acids (DNAs, RNAs). Detection of ribose nucleic acids in saliva is a recent trend in diagnosing oral cancer. Studies have shown statistically significant changes in the levels of salivary transcriptomes in patients with oral squamous cell carcinomas. These biomarkers have displayed high sensitivity and specificity. Also, new point-of-care platforms such as oral fluid nanosensor test are now available that will soon emerge as chair-side tools for early detection of oral cancer. The aim of this review is to highlight the importance of salivary transcriptomes in oral cancer detection.
    Full-text · Article · Dec 2014 · Analytical cellular pathology (Amsterdam)
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    • "The oral cavity has a complex anatomy and represents a difficult area for self examination when compared to that of breast/skin examination. However, patient delay may be reduced by recognition of symptoms and signs (early clinical manifestations) and by educational interventions, especially in the risk groups for oral cancer [72] [74] [79]. Engagement of media (internet, television advertisements and programs, radio, newspaper and magazines, posters, leaflets, electronic communications) for raising oral cancer awareness in the society has been suggested [72] [74] [83] [84]. "
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    ABSTRACT: Stage of disease at the diagnosis of oral cancer is thought to be a significant factor in prognosis and outcome (International Agency for Research on Cancer/World Health Organization, 2014). Unfortunately, we continue to diagnose almost 2/3 of these cancers at advanced stages of disease despite the ongoing research for devices/methods to aid the clinicians in detection and accurate oral mucosal lesion diagnosis. This paper explores both the nature of oral cancer and the adjuncts available for detection, and presents the current issues in diagnostic delays of oral cancer detection.
    Full-text · Article · Sep 2014 · Oral Oncology
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    • "In the early stages, OSCC frequently clinically manifests as inoffensive with asymptomatic lesions. As a consequence, patients are likely to postpone medical care, thus delaying the diagnosis and adequate treatment, resulting in a poorer prognosis (11,12). By contrast, the difficulty in establishing an accurate diagnosis is lower in cases in which the symptoms are more pronounced (3). "
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    ABSTRACT: The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, which were then submitted to modal expression analysis, which considers the higher frequency scores, thus relating the variables. The cytological findings demonstrated that the majority of the cases had malignant potential. Exfoliative cytology should be used as a supplementary tool for the diagnosis of OSCC, as it enables the early detection of these lesions. However, cytology should not be used as a substitute for histopathological examination.
    Full-text · Article · Aug 2014 · Oncology letters
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