title: Patient and tumour factors associated with advanced carcinomas of the head and neck.
abstract: This study identifies patient and tumour related factors associated with advanced carcinoma of the head and neck. Special attention was paid to the role of patient and professional diagnostic delays. Three-hundred and six patients newly diagnosed with carcinoma of the pharynx, larynx and oral cavity were included in the study. Logistic regression analyses were used to identify the risk factors for presenting with an advanced tumour. Multivariate analysis found that having a pharyngeal carcinoma (OR 22.68; p = .000), an oral carcinoma (OR 6.51; p = .000), or a supraglottic carcinoma (OR 8.12; p = .000), patient delay > 3 months (OR 3.47; p = .001) and having a doctors' contact for another reason than the head and neck symptom (OR 0.20; p = .022) were predictive of presenting with an advanced tumour. These results suggest that beyond tumour-related factors, the patients' care seeking behaviour contributes to an increased risk of being diagnosed with an advanced tumour of the head and neck.
authors.affiliation: Julius Centre for Health Sciences and Primary Care, Section Medical and Health Psychology, University Medical Centre Utrecht, STR3. 107, P.O. Box 85060, 3508AB Utrecht, The Netherlands.
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Tromp
authors.forename: Xavier D R
authors.initials: XD
authors.lastname: Brouha
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Hordijk
authors.forename: Jacques A M
authors.initials: JA
authors.lastname: Winnubst
authors.forename: Rob J
authors.initials: RJ
authors.lastname: de Leeuw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D010610:Pharyngeal Neoplasms / Q000175:diagnosis; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors