Causes for delay before specialist consultation in head and neck cancer

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http://hdl.handle.net/10138/311771

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Nieminen , M , Aro , K , Jouhi , L , Bäck , L , Mäkitie , A & Atula , T 2018 , ' Causes for delay before specialist consultation in head and neck cancer ' , Acta Oncologica , vol. 57 , no. 12 , pp. 1677-1686 . https://doi.org/10.1080/0284186X.2018.1497297

Title: Causes for delay before specialist consultation in head and neck cancer
Author: Nieminen, M.; Aro, K.; Jouhi, L.; Bäck, L.; Mäkitie, A.; Atula, T.
Contributor: University of Helsinki, Korva-, nenä- ja kurkkutautien klinikka
University of Helsinki, Department of Ophthalmology and Otorhinolaryngology
University of Helsinki, Clinicum
University of Helsinki, Department of Ophthalmology and Otorhinolaryngology
University of Helsinki, Department of Ophthalmology and Otorhinolaryngology
Date: 2018-12-02
Language: eng
Number of pages: 10
Belongs to series: Acta Oncologica
ISSN: 0284-186X
URI: http://hdl.handle.net/10138/311771
Abstract: Background: Head and neck cancers are often diagnosed at a late stage, thus resulting in a generally poor prognosis. This is partly attributable to patients' hesitancy in seeking treatment. However, the length and causes of these patient delays remain relatively unknown. Material and methods: We included all new head and neck cancer patients treated at our tertiary care center between 2016 and 2017. Using a patient questionnaire, we collected data on patients' symptoms and other factors related to seeking medical care, and recorded both patient- and primary health care-related delays. We then compared the data collected from these patients to patient and tumor characteristics collected from hospital records, and analyzed various causes for delay before a specialist consultation to the Department of Otorhinolaryngology - Head and Neck Surgery. Results: Among the patients (n = 142) in our study, the median patient delay was 35 d with 73% of patients seeking medical care within 3 months. In comparison, the median primary health-care delay was 20 d. Certain symptoms influenced patient delay. Hoarseness and breathing difficulties correlated with longer patient delay while patients with a lump on the neck had a shorter delay. Patient delay was associated with certain tumor-related factors such as the tumor site and the presence of regional metastases, which resulted in shorter patient delay. None of the patient-related factors appeared to impact delay. Important factors influencing primary health-care delay included the initial location visited and whether any follow-up visit was scheduled or not. Conclusions: Although most patients sought medical advice without a major delay and were adequately referred, we found that long delays existed. Raising awareness of the symptoms of head and neck cancer among general population and health-care providers is probably the best way to get patients to curative treatment without delay.
Subject: SQUAMOUS-CELL CARCINOMA
MEDICAL-CARE-SEEKING
DIAGNOSTIC DELAYS
PATIENT DELAY
WAITING-TIMES
ORAL-CANCER
RADIOTHERAPY
SURVIVAL
IMPACT
3122 Cancers
3125 Otorhinolaryngology, ophthalmology
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