title: Diagnostic delay in oral squamous cell carcinoma: the role of cognitive and psychological variables.
abstract: This retrospective study investigated, in two cohorts of subjects living in Southern Italy and awaiting treatment for oral squamous cell carcinoma (OSCC), the variables related to diagnostic delay ascribable to the patient, with particular reference to the cognitive and psychological ones. A total of 156 patients with OSCC (mean age: 62 years, M/F: 2.39∶1) were recruited at the Universities of Palermo and Naples. Risk factors related to patient delay included: sociodemographic, health-related, cognitive and psychological variables. The analysis was conducted by considering two different delay ranges: dichotomous (≤1 month vs. >1 month) and polytomous (<1 month, 1-3 months, >3 months) delay. Data were investigated by univariate and multivariate analyses and a P value ≤0.05 was considered statistically significant. For both delay measurements, the most relevant variables were: 'Personal experience of cancer' (dichotomous delay: P=0.05, odds ratio (OR)=0.33, 95% confidence interval (CI)=0.11-0.99; polytomous delay: P=0.006, Chi-square=10.224) and 'Unawareness' (dichotomous delay: P<0.01, OR=4.96, 95% CI=2.16-11.37; polytomous delay: P=0.087, Chi-square=4.77). Also 'Denial' (P<0.01, OR=6.84, 95% CI=2.31-20.24) and 'Knowledge of cancer' (P=0.079, Chi-square=8.359) were found to be statistically significant both for dichotomous and for polytomous categorization of delay, respectively. The findings of this study indicated that, in the investigated cohorts, the knowledge about cancer issues is strongly linked to the patient delay. Educational interventions on the Mediterranean population are necessary in order to increase the patient awareness and to emphasize his/her key role in early diagnosis of OSCC.
authors.affiliation: Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
authors.forename: Vera
authors.initials: V
authors.lastname: Panzarella
authors.affiliation: Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pizzo
authors.affiliation: Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Calvino
authors.affiliation: Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Compilato
authors.affiliation: Department of Head/Neck Surgery, Oral Cavity and Audio/Verbal Communication, Second University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Colella
authors.affiliation: Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Campisi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001364:Awareness; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000523:psychology; D003071:Cognition; D015331:Cohort Studies; D057210:Delayed Diagnosis; D003717:Denial, Psychological; D005239:Fear / Q000523:psychology; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000523:psychology; D012189:Retrospective Studies; D012959:Socioeconomic Factors