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Assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm Spain. Relative contribution of patient interval

BACKGROUND: Despite continuous advances in diagnosis and therapy, oral cancers are mostly diagnosed at advanced stages with minor survival improvements in the last two decades. Both phenomena have been attributed to delays in the diagnosis. This study aims at quantifying the time elapsed until defin...

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Autores principales: Varela-Centelles, Pablo, López-Cedrún, José-Luis, Fernández-Santromán, Jacinto, Álvarez-Nóvoa, Pablo, Luaces-Rey, Ramón, Pombo-Castro, María-Josefa, López-Jornet, María-Pía, Seoane, Juan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medicina Oral S.L. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549521/
https://www.ncbi.nlm.nih.gov/pubmed/28578373
http://dx.doi.org/10.4317/medoral.21676
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author Varela-Centelles, Pablo
López-Cedrún, José-Luis
Fernández-Santromán, Jacinto
Álvarez-Nóvoa, Pablo
Luaces-Rey, Ramón
Pombo-Castro, María-Josefa
López-Jornet, María-Pía
Seoane, Juan
author_facet Varela-Centelles, Pablo
López-Cedrún, José-Luis
Fernández-Santromán, Jacinto
Álvarez-Nóvoa, Pablo
Luaces-Rey, Ramón
Pombo-Castro, María-Josefa
López-Jornet, María-Pía
Seoane, Juan
author_sort Varela-Centelles, Pablo
collection PubMed
description BACKGROUND: Despite continuous advances in diagnosis and therapy, oral cancers are mostly diagnosed at advanced stages with minor survival improvements in the last two decades. Both phenomena have been attributed to delays in the diagnosis. This study aims at quantifying the time elapsed until definitive diagnosis in these patients and the patient interval’s contribution. MATERIAL AND METHODS: A hospital-based, ambispective, observational study was undertaken on incident cases with a pathological diagnosis of oral squamous cell carcinoma recruited during 2015 at the Oral and Maxillofacial Surgery services of CHUAC (A Coruña) and POVISA (Vigo) hospitals. RESULTS: 74 consecutive oral cancer patients (59.5% males; median age: 65.0 years (IQ:57-74)) were studied. Most cases (52.7%; n=39) were at advanced stages (TNM III-IV) at diagnosis. The period since first sign/symptom until the patient seeks health care was the longest interval in the pathway to diagnosis and treatment (median: 31.5 days; IQR= 7.0 – 61.0) and represents >60% of the interval since symptom onset until referral to specialised care (pre-referral interval). The average interval assigned to the patient resulted to be relatively larger than the time elapsed since the patient is seen at primary care until a definitive diagnosis is reached (diagnostic interval). Median of the referral interval for primary care professionals: 6.5 days (IQR= 0.0 – 49.2) and accounts for 35% (19% - 51%) of the diagnostic interval. CONCLUSIONS: The patient interval is the main component of the pathway to treatment since the detection of a bodily change until the definitive diagnosis. Therefore, strategies focused on risk groups to shorten this interval should be implemented in order to ease an early diagnosis of symptomatic oral cancer. Key words:Oral cancer, early diagnosis, diagnostic delay, time interval, time to diagnosis, Aarhus statement.
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spelling pubmed-55495212017-08-23 Assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm Spain. Relative contribution of patient interval Varela-Centelles, Pablo López-Cedrún, José-Luis Fernández-Santromán, Jacinto Álvarez-Nóvoa, Pablo Luaces-Rey, Ramón Pombo-Castro, María-Josefa López-Jornet, María-Pía Seoane, Juan Med Oral Patol Oral Cir Bucal Research BACKGROUND: Despite continuous advances in diagnosis and therapy, oral cancers are mostly diagnosed at advanced stages with minor survival improvements in the last two decades. Both phenomena have been attributed to delays in the diagnosis. This study aims at quantifying the time elapsed until definitive diagnosis in these patients and the patient interval’s contribution. MATERIAL AND METHODS: A hospital-based, ambispective, observational study was undertaken on incident cases with a pathological diagnosis of oral squamous cell carcinoma recruited during 2015 at the Oral and Maxillofacial Surgery services of CHUAC (A Coruña) and POVISA (Vigo) hospitals. RESULTS: 74 consecutive oral cancer patients (59.5% males; median age: 65.0 years (IQ:57-74)) were studied. Most cases (52.7%; n=39) were at advanced stages (TNM III-IV) at diagnosis. The period since first sign/symptom until the patient seeks health care was the longest interval in the pathway to diagnosis and treatment (median: 31.5 days; IQR= 7.0 – 61.0) and represents >60% of the interval since symptom onset until referral to specialised care (pre-referral interval). The average interval assigned to the patient resulted to be relatively larger than the time elapsed since the patient is seen at primary care until a definitive diagnosis is reached (diagnostic interval). Median of the referral interval for primary care professionals: 6.5 days (IQR= 0.0 – 49.2) and accounts for 35% (19% - 51%) of the diagnostic interval. CONCLUSIONS: The patient interval is the main component of the pathway to treatment since the detection of a bodily change until the definitive diagnosis. Therefore, strategies focused on risk groups to shorten this interval should be implemented in order to ease an early diagnosis of symptomatic oral cancer. Key words:Oral cancer, early diagnosis, diagnostic delay, time interval, time to diagnosis, Aarhus statement. Medicina Oral S.L. 2017-07 2017-06-04 /pmc/articles/PMC5549521/ /pubmed/28578373 http://dx.doi.org/10.4317/medoral.21676 Text en Copyright: © 2017 Medicina Oral S.L. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Varela-Centelles, Pablo
López-Cedrún, José-Luis
Fernández-Santromán, Jacinto
Álvarez-Nóvoa, Pablo
Luaces-Rey, Ramón
Pombo-Castro, María-Josefa
López-Jornet, María-Pía
Seoane, Juan
Assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm Spain. Relative contribution of patient interval
title Assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm Spain. Relative contribution of patient interval
title_full Assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm Spain. Relative contribution of patient interval
title_fullStr Assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm Spain. Relative contribution of patient interval
title_full_unstemmed Assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm Spain. Relative contribution of patient interval
title_short Assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm Spain. Relative contribution of patient interval
title_sort assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm spain. relative contribution of patient interval
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549521/
https://www.ncbi.nlm.nih.gov/pubmed/28578373
http://dx.doi.org/10.4317/medoral.21676
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