Delay in the Diagnosis of Patients With Head and Neck Cancer: Impact of Different Patient- and Healthcare Provider-Related Factors.

Autor:	Khurshied S; Otolaryngology - Head and Neck Surgery, Pakistan Institute of Medical Sciences, Islamabad, PAK., Shahid Z; Otolaryngology - Head and Neck Surgery, Akhtar Saeed Medical College, Rawalpindi, PAK., Wazir T; Otolaryngology - Head and Neck Surgery, Pakistan Institute of Medical Sciences, Islamabad, PAK., Ullah I; Otolaryngology - Head and Neck Surgery, Pakistan Institute of Medical Sciences, Islamabad, PAK., Sagheer S; Medicine and Surgery, Rawal Institute of Health Sciences, Islamabad, PAK., Khurshid N; Otolaryngology - Head and Neck Surgery, Pakistan Institute of Medical Sciences, Islamabad, PAK., Hussain A; Otolaryngology - Head and Neck Surgery, Pakistan Institute of Medical Sciences, Islamabad, PAK.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 03; Vol. 16 (9), pp. e68528. Date of Electronic Publication: 2024 Sep 03 (Print Publication: 2024).
DOI:	10.7759/cureus.68528
Abstrakt:	Background In our setup, head and neck cancer (HNC) is the most common, and patients frequently present at an advanced stage, which results in dismal outcomes. Delays on the part of the patient (such as resistance to seeking treatment) or the provider (such as misdiagnosis or an extended wait period for consultation) may be the cause of a late presentation. The presentation stage may vary depending on several factors, including age, gender, smoking status, job status, and education. Objectives The study aims to identify factors that lead to advanced-stage presentations of HNCs and to determine the delays brought on by patient- or healthcare provider-related factors and how these factors affect HNC disease staging among biopsy-proven HNC patients. Materials and methods Participants in the study were those who initially presented with a biopsy-verified HNC at the cancer clinic of the department of otolaryngology-head and neck surgery at Pakistan Institute of Medical Sciences (PIMS), Islamabad. Patients answered questions on their first symptom presentation, past healthcare professional visits, and intervals between visits on a Cancer Symptom Interval Measure (C-SIM) questionnaire. For every patient, clinical and demographic information was gathered. TNM staging was completed. The test of significance was applied where applicable. Results Age, gender, education level, and smoking status had no bearing on the presentation stage. Patients without jobs present at a statistically significant higher stage (p = 0.038). The most prevalent histological form of HNC was squamous cell carcinoma 79 (82.29%), with the oral cavity and larynx being the most common sites of the disease 30 (31.25%) and 29 (30.21%) respectively. Patients took an average of 5.28 ± 9.12 months from the onset of symptoms to their first appointment with a healthcare provider. Prior to diagnosis, the majority of patients saw three or more healthcare providers (range: 1-8). The duration from the initial visit to a healthcare provider to the initiation of treatment was 3.06 ± 5.88 months. Based on the stage at presentation, there were no discernible variations in the times to presentation (p>0.05). Conclusion Significant delays and high stage of presentation are caused by unemployment. The majority of the delay was caused by the patient's tardiness in seeing a medical practitioner, yet the presentation stage was not greatly impacted by this delay. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Research Review Board, Pakistan Institute of Medical Sciences, Islamabad issued approval F.3-1/2023(ERRB)/Chairman. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Khurshied et al.)
Databáze:	MEDLINE
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