Delays in diagnosis of head and neck cancers

Background: Delayed diagnosis of head and neck cancer is often caused by patient-related factors. However, the primary health care provider may also be responsible. Objectives: To define patient, professional and total delay, and to identify factors that may increase delay. Methods: The study group consisted of 102 patients with oral or pharyngeal cancer referred to Princess Margaret Hospital, Toronto, Ontario. The study took place from September 2005 to September 2006. Results: Median patient, professional and total delays were 4.5 weeks, 11.8 weeks and 22.5 weeks, respectively. Significantly longer delays were found among women (p < 0.01), non-smokers (p < 0.01), patients who were not referred following initial consultation (p < 0.001) and patients who did not visit their dentist (p < 0.05). Conclusions: Clinicians should adopt a "universal index of suspicion" in screening for head and neck cancer, with attention to the risk indicators for delay. Patients must also be encouraged to visit their dentist regularly to increase the rate of early detection.