Exploring the reasons for delay in treatment of oral cancer

J Am Dent Assoc. 2008 Oct;139(10):1346-52. doi: 10.14219/jada.archive.2008.0046.


Background: Oral cancer continues to be diagnosed and treated at a late stage, which has a negative effect on outcomes. This study identified and quantified delays in diagnosis and treatment.

Methods: The authors conducted a study that included all new patients seen in the Department of Oral and Maxillofacial Surgery, University of California, San Francisco, between 2003 and 2007 who had a diagnosis of squamous cell carcinoma of the oral cavity. They identified the time intervals for six stages, beginning with the time at which patients first became aware of symptoms and ending with the time at which definitive treatment began.

Results: The total time from patients' first sign or symptoms to commencement of treatment was a mean of 205.9 days (range, 52-786 days). The longest delay was from the time symptoms first appeared to the initial visit to a health care professional (mean time, 104.7 days; range, 0-730 days).

Conclusions: Health care professionals need to place greater emphasis on patient education to encourage early self-referrals.

Clinical implications: Patients should be encouraged to visit a health care professional when signs or symptoms of oral cancer first develop.

MeSH terms

  • Attitude to Health
  • Biopsy
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / therapy*
  • Early Diagnosis
  • Humans
  • Mouth Neoplasms / diagnosis
  • Mouth Neoplasms / therapy*
  • Patient Acceptance of Health Care
  • Patient Care Planning
  • Patient Education as Topic
  • Primary Health Care
  • Referral and Consultation
  • San Francisco
  • Time Factors