title: Early oral cancer diagnosis: The Aarhus statement perspective. A systematic review and meta-analysis.
abstract: Mortality is linked to diagnostic intervals in certain cancers. As symptom perception is conditioned by tumor site, a specific study on oral cancer is needed.
  
  
  
  This study's inclusion criteria were original data, symptomatic primary oral squamous cell carcinoma, and exposure of interest, diagnostic interval, or diagnostic delay. The outcome of interest was survival and disease stage. A meta-analysis was undertaken to investigate the relationship between intervals to diagnosis, TNM classification, and survival in oral cancer.
  
  
  
  Regarding referral delay, the results present no heterogeneity and showed a risk increase in mortality of 2.48 (range = 1.39-4.42). The larger the diagnostic delay, the more advanced the stage at diagnosis. High quality studies reveal a higher risk increase than low quality studies (odds ratio [OR] = 2.44; 95% confidence interval [CI] = 1.36-4.36 vs OR = 1.53; 95% CI = 1.26-1.86).
  
  
  
  A longer time interval from first symptom to referral for diagnosis is a risk factor for advanced stage and mortality of oral cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2182-E2189, 2016.
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Seoane
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Alvarez-Novoa
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: Iria
authors.initials: I
authors.lastname: Gomez
authors.affiliation: Department of Preventive Medicine, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: Bahi
authors.initials: B
authors.lastname: Takkouche
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Diz
authors.affiliation: Department of Oral Medicine, King's College, Dental Institute, London, United Kingdom.
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasiruya
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Seoane-Romero
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.|Galician Health Service, EOXI Lugo, Cervo e Monforte de Lemos, Lugo, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Varela-Centelles
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D057210:Delayed Diagnosis; D055088:Early Detection of Cancer; D006801:Humans; D009062:Mouth Neoplasms / Q000175:diagnosis*; D009367:Neoplasm Staging
keywords: diagnostic delay; meta-analysis; oral cancer; survival; time interval; tumor stage