Delay in the diagnosis of oral cancer in India, time to focus toward capacity building of physicians: A prospective observational study.

Abstract

Background: Delay in diagnosis of head and neck cancers is responsible for advanced presentation of the disease leading to increased morbidity and mortality.

Methods: A questionnaire-based prospective observational study consisting of 150 patients was performed in a tertiary care center established in North India. The factors responsible for professional and patient delay including demographic details and the clinical examination findings, health-related behavior, socio-economic status based on modified Kuppuswamy's scale, and the health care factors were also evaluated.

Results: The mean age of the patients at the time of diagnosis was 48.32 years (S.D: 12.467 and range 27-80 years). Male patients showed predominance with a ratio of 11.5:1. Buccoalveolar cancers were the most common sites, whereas 55% had nodal metastasis and 70% were advanced stage cancers. Overall advanced stage patients (p < 0.02) and node positive patients (p < 0.04) were present significantly more in those with the physician's delay (P1D). There was higher P1D in patients with no tobacco habits (76.9% vs 53.3%) (p < 0.05). Self-motivated individuals had significantly shorter patient delay (p < 0.00); however, physician delay was similar.

Conclusion: Circumventing physicians delay by training and capacity building of the general physicians will lead to early diagnosis and timely treatment of the head and neck cancer patients.