Delay in Diagnosis of Patients with Head-and-Neck Cancer in Canada: Impact of Patient and Provider Delay
| Autor: | Nancy Read, S Kassirian, David A. Palma, Anthony C. Nichols, Adrian Mendez, Varagur Venkatesan, Kevin Fung, A Dzioba, Axel Sahovaler, S.D. MacNeil, S Hamel, Krupal B. Patel, John Yoo |
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| Rok vydání: | 2020 |
| Předmět: |
Canada
head-and-neck cancer medicine.medical_specialty Delayed Diagnosis Referral Health care provider Health Personnel Delay in presentation delay in presentation Ambulatory Care Facilities Pediatrics Tertiary care 03 medical and health sciences 0302 clinical medicine Clinical pathway Humans Medicine 030212 general & internal medicine Stage (cooking) Referral and Consultation business.industry Head and neck cancer medicine.disease Wait time Head and Neck Neoplasms patient-reported outcomes 030220 oncology & carcinogenesis Emergency medicine Original Article Presentation (obstetrics) business |
| Zdroj: | Paediatrics Publications Curr Oncol Current Oncology Volume 27 Issue 5 Pages 6547-477 |
| ISSN: | 1718-7729 |
| DOI: | 10.3747/co.27.6547 |
| Popis: | Head-and-neck cancers (hncs) often present at an advanced stage, leading to poor outcomes. Late presentation might be attributable to patient delays (reluctance to seek treatment, for instance) or provider delays (misdiagnosis, prolonged wait time for consultation, for example). The objective of the present study was to examine the length and cause of such delays in a Canadian universal health care setting. Patients presenting for the first time to the hnc multidisciplinary team (mdt) with a biopsy-proven hnc were recruited to this study. Patients completed a survey querying initial symptom presentation, their previous medical appointments, and length of time between appointments. Clinical and demographic data were collected for all patients. The average time for patients to have their first appointment at the mdt clinic was 15.1 months, consisting of 3.9 months for patients to see a health care provider (hcp) for the first time since symptom onset and 10.7 months from first hcp appointment to the mdt clinic. Patients saw an average of 3 hcps before the mdt clinic visit (range: 1&ndash 7). No significant differences in time to presentation were found based on stage at presentation or anatomic site. At our tertiary care cancer centre, a patient&rsquo s clinical pathway to being seen at the mdt clinic shows significant delays, particularly in the time from the first hcp visit to mdt referral. Possible methods to mitigate delay include education about hnc for patients and providers alike, and a more streamlined referral system. |
| Databáze: | OpenAIRE |
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