title: Delay in seeking specialized care for oral cancers: experience from a tertiary cancer center.
abstract: OBJECTIVE
  Advanced oral cancers are a challenge for treatment, as they require complex procedures for excision and reconstruction. Despite being occurring at a visible site and can be detected easily, many patients present in advanced stages with large tumors. Timely intervention is important in improving survival and quality of life in these patients. The aim of the present study was to find out the causes of delay in seeking specialist care in advanced oral cancer patients.
  
  
  METHODS
  A prospective questionnaire based study was done on 201 consecutive advanced oral squamous cancer patients who underwent surgery at our hospital. All patients had either cancer of gingivobuccal complex (GBC) or tongue and had tumors of size more than 4 cm (T3/T4) and were treatment naοve at presentation.
  
  
  RESULTS
  Even though most patients observed abnormal lesions in their mouth, majority delayed the decision to visit a physician early. A significant percentage of patients (50%) also reported a delayed diagnosis by the primary care physician before being referred to a tertiary care center for definitive treatment. The average total duration from symptoms to treatment was 7 months.
  
  
  CONCLUSIONS
  The main reasons of this delay in receiving treatment were due to patients themselves (primary delay) or due to time taken by the primary physician to diagnose the condition (secondary delay). Oral self-examination can be helpful in detecting oral cancers early.
authors.forename: P
authors.initials: P
authors.lastname: Joshi
authors.affiliation: Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: S
authors.initials: S
authors.lastname: Nair
authors.forename: P
authors.initials: P
authors.lastname: Chaturvedi
authors.forename: D
authors.initials: D
authors.lastname: Nair
authors.forename: J P
authors.initials: JP
authors.lastname: Agarwal
authors.forename: A K
authors.initials: AK
authors.lastname: D'Cruz
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers