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Time intervals from first symptom to diagnosis for head and neck cancers: An analysis of linked patient reports and medical records from the UK |
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| Affiliation: | 1. Hull York Medical SchoolDepartment of Health Sciences, University of York, Heslington Lane, York, YO10 5DD, United Kingdom;2. Hull York Medical School, Allam Medical Building, University of Hull, Hull, HU6 7RX, United Kingdom;1. Servicio de Otorrinolaringología, Hospital Universitario Doctor Peset, Valencia, España;2. Servicio de Otorrinolaringología, Hospital Francesc de Borja, Gandía, Valencia, España;1. Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;2. Department of Health and Human Performance, University of Houston, TX, USA;3. Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;1. Southport and Ormskirk NHS Foundation Trust, Town Lane, Kew, Southport, PR8 6PN;2. Evidence-Based Practice Research Centre (EPRC), Edge Hill University, St Helens Road, Ormskirk, L39 4QP;3. University Hospital Aintree, Liverpool, L9 1AE, UK;1. University of Oxford, UK;2. Royal Blackburn Hospital, Blackburn, UK;3. Nuffield Department of Primary Care Health Sciences, University of Oxford, UK |
| Abstract: | BackgroundEngland has significantly higher mortality risks due to Head and Neck Cancer (HNC) compared with other European countries. Early diagnosis is important as it is likely to increase early-stage diagnosis and improve survival and better quality of life. This study sought to improve understanding of the intervals from first symptom recognition to diagnosis for HNC and investigate associations between patient-reported symptoms and socio-demographic factors.MethodsPeople within 3 months of diagnosis, completed a researcher-administered questionnaire and data were extracted from primary and secondary care clinical records.ResultsEighty (mean age 62.9 [SD 11.7] years; 66% men) were interviewed. The appraisal interval was longer than a month for 39% of participants and the help-seeking interval was longer than a week for 44%. The median diagnostic interval was 92 (IQR; 34-172) days. Appraisal intervals of > 1 month were associated with male gender, ulceration and persistent throat pain. The only symptom that associated with a help-seeking interval of > 1 week was ulceration. Participants who reported red/white patches in the mouth and ulceration were associated with a reduced likelihood of a diagnostic interval of > 3 months. A higher proportion of participants with a diagnostic interval of > 3 months were diagnosed with advanced disease (78%) than those with an interval < 3 months (68%).ConclusionThese data improve understanding of the intervals from first symptom recognition to HNC diagnosis and provide preliminary evidence to identify targets to reduce overall time to diagnosis. |
| Keywords: | Early detection of cancer Head and neck neoplasms Oral ulcer Surveys and questionnaires Logistic models Odds ratio Hospital records Secondary care Primary health care |
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