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Current Oncology
Volume 27
Issue 5
10.3747/co.27.6547
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Delay in Diagnosis of Patients with Head-and-Neck Cancer in Canada: Impact of Patient and Provider Delay

by
S. Kassirian
1,
A. Dzioba
2,
S. Hamel
2,
K. Patel
3,
A. Sahovaler
2,
D.A. Palma
4,
N. Read
4,
V. Venkatesan
4,
A.C. Nichols
2,
J. Yoo
2,
K. Fung
2,
A. Mendez
2 and
S.D. MacNeil
2,*
1
Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON, Canada
2
Department of Otolaryngology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON, Canada
3
Department of Otolaryngology, Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, USA
4
Department of Radiation Oncology, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, London, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2020, 27(5), 467-477; https://doi.org/10.3747/co.27.6547
Submission received: 2 July 2020 / Revised: 5 August 2020 / Accepted: 11 September 2020 / Published: 1 October 2020

Abstract

Background: 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. Methods: 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. Results: 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: 1–7). No significant differences in time to presentation were found based on stage at presentation or anatomic site. Conclusions: At our tertiary care cancer centre, a patient’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.
Keywords: delay in presentation; head-and-neck cancer; patient-reported outcomes delay in presentation; head-and-neck cancer; patient-reported outcomes

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MDPI and ACS Style

Kassirian, S.; Dzioba, A.; Hamel, S.; Patel, K.; Sahovaler, A.; Palma, D.A.; Read, N.; Venkatesan, V.; Nichols, A.C.; Yoo, J.; et al. Delay in Diagnosis of Patients with Head-and-Neck Cancer in Canada: Impact of Patient and Provider Delay. Curr. Oncol. 2020, 27, 467-477. https://doi.org/10.3747/co.27.6547

AMA Style

Kassirian S, Dzioba A, Hamel S, Patel K, Sahovaler A, Palma DA, Read N, Venkatesan V, Nichols AC, Yoo J, et al. Delay in Diagnosis of Patients with Head-and-Neck Cancer in Canada: Impact of Patient and Provider Delay. Current Oncology. 2020; 27(5):467-477. https://doi.org/10.3747/co.27.6547

Chicago/Turabian Style

Kassirian, S., A. Dzioba, S. Hamel, K. Patel, A. Sahovaler, D.A. Palma, N. Read, V. Venkatesan, A.C. Nichols, J. Yoo, and et al. 2020. "Delay in Diagnosis of Patients with Head-and-Neck Cancer in Canada: Impact of Patient and Provider Delay" Current Oncology 27, no. 5: 467-477. https://doi.org/10.3747/co.27.6547

APA Style

Kassirian, S., Dzioba, A., Hamel, S., Patel, K., Sahovaler, A., Palma, D. A., Read, N., Venkatesan, V., Nichols, A. C., Yoo, J., Fung, K., Mendez, A., & MacNeil, S. D. (2020). Delay in Diagnosis of Patients with Head-and-Neck Cancer in Canada: Impact of Patient and Provider Delay. Current Oncology, 27(5), 467-477. https://doi.org/10.3747/co.27.6547

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