title: Role of alcohol and smoking in diagnostic delay of head and neck cancer patients.
abstract: CONCLUSIONS
  This study shows that heavy drinking is a risk factor for prolonged delay in presenting with head and neck cancer and for presenting with a large tumour in the head and neck region. Excessive smoking is only a risk factor for being diagnosed with a large tumour, although there is a weak association between smoking and prolonged diagnostic delay.
  
  
  OBJECTIVE
  It is reasonable to assume that prolonged delay in presenting with head and neck cancer is associated with an advanced stage of cancer at diagnosis. In this study we analysed the effects of drinking and smoking habits on diagnostic delay and the T stage of the tumour at diagnosis.
  
  
  METHODS
  A total of 427 patients with newly diagnosed head and neck carcinomas were eligible for this study. Of these, 306 (72%) actually participated: 134 (77%) with an oral tumour; 117 (69%) with a larynx tumour; and 55 (65%) with a pharynx tumour. Diagnostic delay was defined as a period of >30 days between the appearance of the first tumour-related symptoms and the first visit to a physician. T3 4 tumours were defined as advanced tumours. Drinking behaviour was classified into three types: light (0 2 drinks/day); moderate (3 4 drinks/day); and heavy ( >4 drinks/day). Smoking habits were classified into 4 types: never; stopped; light (0 20 cigarettes/day); and heavy (>20 cigarettes/day).
  
  
  RESULTS
  Logistic regression showed that there were significantly more heavy than light drinkers [p = 0.04; odds ratio (OR) 1.8; 95% CI 1.0-3.1] in the delay group than in the non-delay group. Light smokers showed a tendency towards prolonged delay (p = 0.06; OR 2.2; 95% CI 1.0-5.0). Both heavy drinking (p = 0.01; OR 2.0; 95% CI 1.2-3.6) and heavy smoking (p = 0.03; OR 3.1; 95% CI 1.1-8.4) were risk factors for a patient to be diagnosed with a large tumour.
authors.affiliation: Department of Otorhinolaryngology, University Medical Centre, Julius Centre for Health Sciences and Primary Care, Utrecht, The Netherlands. xbrouha@kmb.azu.nl
authors.forename: Xavier
authors.initials: X
authors.lastname: Brouha
authors.forename: Debbie
authors.initials: D
authors.lastname: Tromp
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Hordijk
authors.forename: Jacques
authors.initials: J
authors.lastname: Winnubst
authors.forename: Rob
authors.initials: R
authors.lastname: De Leeuw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000473:pathology*; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D012907:Smoking / Q000453:epidemiology*