title: Delays in diagnosis of head and neck cancers.
abstract: BACKGROUND
  Delayed diagnosis of head and neck cancer is often caused by patient related factors. However, the primary health care provider may also be responsible.
  
  
  OBJECTIVE
  To define patient, professional and total delay, and to identify factors that may increase delay.
  
  
  METHODS
  The study group consisted of 102 patients with oral or pharyngeal cancer referred to Princess Margaret Hospital, Toronto, Ontario. The study took place from September 2005 to September 2006.
  
  
  RESULTS
  Median patient, professional and total delays were 4.5 weeks, 11.8 weeks and 22.5 weeks, respectively. Significantly longer delays were found among women(p < 0.01), non-smokers (p < 0.01), patients who were not referred following initial consultation(p < 0.001) and patients who did not visit their dentist (p < 0.05).
  
  
  CONCLUSIONS
  Clinicians should adopt a "universal index of suspicion" in screening for head and neck cancer, with attention to the risk indicators for delay. Patients must also be encouraged to visit their dentist regularly to increase the rate of early detection.
authors.affiliation: University of Toronto, Toronto, Ontario.
authors.forename: Thomas
authors.initials: T
authors.lastname: Yu
authors.forename: Robert E
authors.initials: RE
authors.lastname: Wood
authors.forename: Howard C
authors.initials: HC
authors.lastname: Tenenbaum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004498:Education, Dental, Continuing; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D012017:Referral and Consultation; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors