A Pilot Study on Factors Associated with Presentation Delay in Patients Affected with Head and Neck Cancers

  • Baishya, Nizara (Head and Neck Oncology, Epidemiology and Biostatistics. Dr.B Borooah Cancer Institute) ;
  • Das, Ashok Kumar (Head and Neck Oncology, Epidemiology and Biostatistics. Dr.B Borooah Cancer Institute) ;
  • Krishnatreya, Manigreeva (Cancer Registry, Epidemiology and Biostatistics. Dr.B Borooah Cancer Institute) ;
  • Das, Anupam (Head and Neck Oncology, Epidemiology and Biostatistics. Dr.B Borooah Cancer Institute) ;
  • Das, Kishore (Head and Neck Oncology, Epidemiology and Biostatistics. Dr.B Borooah Cancer Institute) ;
  • Kataki, Amal Chandra (Head and Neck Oncology, Epidemiology and Biostatistics. Dr.B Borooah Cancer Institute) ;
  • Nandy, Pintu (Cancer Registry, Epidemiology and Biostatistics. Dr.B Borooah Cancer Institute)
  • Published : 2015.06.26


Background: Patient delay can contribute to a poor outcome in the management of head and neck cancers (HNC). The main objective of the present study was to investigate the factors associated with patient delay in our population. Materials and Methods: Patients with cancers of the head and neck attending a regional cancer center of North East India were consecutively interviewed during the period from June 2014 to November 2014. The participation of patients was voluntary. The questionnaire included information on age, gender, residential status, educational qualification, monthly family income, any family history of cancer, and history of prior awareness on cancer from television (TV) program and awareness program. Results: Of 311 (n) patients, with an age range of 14-88 years (mean 55.4 years), 81.7% were males and 18.3% females (M:F=4.4). The overall median delay was 90 days (range=7 days-365 days), in illiterate patients the median delay was 90 days and 60 days in literate patients (P=0.002), the median delay in patients who had watched cancer awareness program on TV was 60 days and in patients who were unaware about cancer information from TV program had a median delay of 90 days (p=0.00021) and delay of <10 weeks was seen in 139 (44.6%) patients, a delay of 10-20 weeks in 98 (31.5%) patients, and a delay of 20-30 weeks in 63 (20.2%) patients. Conclusions: Education and awareness had a significant impact in reduction of median patient delay in our HNC cases.


  1. Baughan P, O'Neil B, Fletcher E (2009). Auditing the diagnosis of cancer in primary care: the experience in Scotland. BMJ, 101, 87-91.
  2. Dwivedi AK, Dwivedi SA, Deo S, et al (2012). An epidemiological study on delay in treatment initiation of cancer patients. Health, 4, 66-79.
  3. Esmaelbeigi F, Hadji M, Harirchi I, et al (2014). Factors affecting professional delay in diagnosis and treatment of oral cancer in Iran. Arch Iran Med, 17, 253-7.
  4. Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, et al (2014). Challenges to effective cancer control in China, India, and Russia. Lancet Oncol, 15, 489-538.
  5. Goy J, Hall SF, Feldman-Stewart D, Groome PA (2009). Diagnostic delay and disease stage in head and neck cancer: a systematic review. Laryngoscope, 119, 889-98.
  6. Hansen RP, Olesen F, Sorensen HT, Sokolowski I, Sondergaard J (2008). Socioeconomic patient characteristics predict delay in cancer diagnosis: a Danish cohort study. BMC Health Serv Res, 8, 49.
  7. Hansen RP, Vedsted P, Sokolowski I, et al (2011). Time intervals from first symptom to treatment of cancer: a cohort study of 2,212 newly diagnosed cancer patients. BMC Health Serv Res, 11, 284.
  8. Horner-Johnson W, Dobbertin K, Lee JC, Andresen EM (2014). Rural disparities in receipt of colorectal cancer screening among adults ages 50-64 with disabilities. Disabil Health J, 7, 394-401.
  9. Jensen AR, Nellemann HM, Overgaard J (2007). Tumor progression in waiting time for radiotherapy in head and neck cancer. Radiother Oncol, 84, 5-10.
  10. Joshi P, Dutta S, Chaturvedi P, Nair S (2014). Head and neck cancers in developing countries. Rambam Maimonides Med J, 5, 9.
  11. Joshi P, Nair S, Chaturvedi P, et al (2014). Delay in seeking specialized care for oral cancers: Experience from a tertiary cancer center. Indian J Cancer, 51, 95-7.
  12. Keeble S, Abel GA, Saunders CL, et al (2014). Variation in promptness of presentation among 10,297 patients subsequently diagnosed with one of 18 cancers: evidence from a national audit of cancer diagnosis in Primary Care. Int J Cancer, 135, 1220-8.
  13. Krishnatreya M, Kataki AC, Sharma JD, et al (2014). Educational levels and delays in start of treatment for head and neck cancers. Asian Pac J Cancer Prev, 15, 10867-9.
  14. Morelatto RA, Herrera MC, Fernandez EN, Corball AG, Lopez de Blanc SA (2007). Diagnostic delay of oral squamous cell carcinoma in two diagnosis centers in Cordoba Argentina. J Oral Pathol Med, 36, 405-8.
  15. National Cancer Registry Programme (2013). Consolidated report of hospital based cancer registries:2007-2011. NCDIR-ICMR, Bangalore.
  16. Saleh A, Yang YH, Wan Abd Ghani WM, et al (2012). Promoting oral cancer awareness and early detection using a mass media approach. Asian Pac J Cancer Prev, 13, 1217-24.
  17. Salem A (2010). Dismissing links between HPV and aggressive tongue cancer in young patients. Ann Oncol, 21, 13-17
  18. Stefanuto P, Doucet JC, Robertson C (2014). Delays in treatment of oral cancer: A review of the current literature. Oral Surg Oral Med Oral Pathol Oral Radiol, 117, 424-9.
  19. Tripathi N, Kadam YR, Dhobale RV, Gore AD (2014). Barriers for early detection of cancer amongst Indian rural women. South Asian J Cancer, 3, 122-7.
  20. Tromp DM, Brouha XD, De Leeuw JR, Hordijk GJ, Winnubst JA (2004). Psychological factors and patient delay in patients with head and neck cancer. Eur J Cancer, 40, 1509-16.
  21. Yu T, Wood RE, Tenenbaum HC (2008). Delays in diagnosis of head and neck cancers. Appl Res, 74, 61.

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