Causes for delay before specialist consultation in head and neck cancer

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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 organization: Korva-, nenä- ja kurkkutautien klinikka
Clinicum
University of Helsinki
Department of Ophthalmology and Otorhinolaryngology
HUS Head and Neck Center
Date: 2018-12-02
Language: eng
Number of pages: 10
Belongs to series: Acta Oncologica
ISSN: 0284-186X
DOI: https://doi.org/10.1080/0284186X.2018.1497297
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
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: acceptedVersion


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