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- Title
Causes for delay before specialist consultation in head and neck cancer.
- Authors
Nieminen, M.; Aro, K.; Jouhi, L.; Bäck, L.; Atula, T.; Mäkitie, A.
- 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.
- Subjects
HEAD tumors; NECK tumors; HELP-seeking behavior; HOARSENESS; MEDICAL appointments; MEDICAL care; MEDICAL referrals; METASTASIS; PRIMARY health care; QUESTIONNAIRES; RESPIRATION; MEDICAL records; TREATMENT delay (Medicine); TERTIARY care; TUMOR treatment
- Publication
Acta Oncologica, 2018, Vol 57, Issue 12, p1677
- ISSN
0284-186X
- Publication type
Article
- DOI
10.1080/0284186X.2018.1497297