Impact of delay in the diagnosis and treatment of head and neck cancer

Felippu, André Wady Debes; Freire, Eduardo Cesar; Silva, Ricardo de Arruda; Guimarães, André Vicente; Dedivitis, Rogério Aparecido

doi:10.1016/j.bjorl.2015.10.009

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ORIGINAL ARTICLES • Braz. j. otorhinolaryngol. 82 (2) • Mar-Apr 2016 • https://doi.org/10.1016/j.bjorl.2015.10.009 linkcopy

Impact of delay in the diagnosis and treatment of head and neck cancer ^{^☆} ^{^☆☆}

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

INTRODUCTION: Head and neck tumors can be easily recognized through clinical evaluation. However, they are often diagnosed at advanced stages.

OBJECTIVE: To evaluate the delay from the patient's initial symptoms to the definitive treatment.

METHODS: Retrospective study of patients enrolled in 2011 and 2012. A questionnaire was filled in about socioeconomic aspects, patient history, tumor data, professionals who evaluated the patients, and the respective time delays.

RESULTS: The following time delay medians were observed: ten months between symptom onset and the first consultation; four weeks between the latter and the first consultation with a specialist; four weeks between the specialist consultation and diagnosis attainment; and 12 weeks between diagnosis and the start of treatment.

CONCLUSIONS: Most head and neck tumors are diagnosed at advanced stages, due to patient and health care factors.

Keywords:
Delayed diagnosis; Head and neck neoplasms; Squamous cell carcinoma; Time factors; Primary health care; Prognosis

	n	%
Gender
Male	75	93.75
Female	5	6.25

Ethnicity
White	63	78.75
Non-white	17	21.5

Smoking
Regular smoker	79	98.75
Non-smoker	1	1.25

Alcohol consumption
Regular user	42	52.5
Non-user	38	47.5

Level of schooling
<Elementary school	42	52.5
Elementary school	32	40
<High school	3	3.75
High school	3	3.75

Primary sites
Lips	2	2.5
Oral cavity	33	41.25
Oropharynx	8	10
Hypopharynx	5	6.25
Larynx	25	31.25
Paranasal sinuses	3	3.75
Primary occult	4	5

Clinical staging
EC I	5	6.25
EC II	8	10
EC III	23	28.75
EC IV	44	55

Main modality of referral
Surgery	23	28.75
Radiotherapy	52	65
Chemotherapy (palliative)	5	6.25

Interval	Median	Range
Symptom onset – seeking health care service (months)	10	8–48
First consultation with a general practitioner – first consultation with a specialist (weeks)	4	2–180
First consultation with a specialist – establishing the diagnosis (weeks)	4	2–8
Diagnosis – start of the treatment (weeks)	12	2–16

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Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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Impact of delay in the diagnosis and treatment of head and neck cancer ☆ ☆☆

ABSTRACT

Impact of delay in the diagnosis and treatment of head and neck cancer ^{^☆} ^{^☆☆}