title: Factors associated with delay in presentation among younger patients with oral cancer.
abstract: Despite the reported increase in the incidence of oral squamous cell carcinoma (OSCC) in under 45-year-olds, little is known regarding the pattern and reasons for delay in presentation in this younger age group. The aim of this study was to investigate factors predictive of patient (primary) delay in a sample of 53 newly diagnosed patients under the age of 45 years. Multiple logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for primary delay (> or = 21 days between patient first noticing signs or symptoms and seeking professional advice). Self-reported delay ranged from less than 1 week to 104 weeks, with a median of 5 weeks. A total of 33 patients (62%) reported a delay of at least 21 days. Three variables: lack of further education, perceptions of being under stress in the period prior to diagnosis, and lower amounts of tobacco smoked per day were included in the final model and together explained 43% of the variance in patient delay (R2 = 0.432). Although OSCC is relatively rare in this age group, the rise in incidence and the change in profile of risk factors may increase the odds of patient delay. This has important implications for increasing sign and symptom awareness among the public and primary health care professionals such as general medical practitioners and general dentists.
authors.affiliation: Department of Oral medicine and Pathology, WHO Collaborating Centre for Oral Cancer and Precancer, Guy's , King's, and St Thomas' Schools of Medicine and Dentistry, King's College London, UK.
authors.forename: Carrie D
authors.initials: CD
authors.lastname: Llewellyn
authors.forename: Newell W
authors.initials: NW
authors.lastname: Johnson
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
mesh_terms: D000293:Adolescent; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D016001:Confidence Intervals; D004522:Educational Status; D005260:Female; D005544:Forecasting; D015438:Health Behavior; D006267:Health Education, Dental; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D012907:Smoking; D012923:Social Class; D013315:Stress, Psychological / Q000523:psychology; D013997:Time Factors