title: Factors associated with delays in head and neck cancer treatment: case-control study.
abstract: BACKGROUND
  Delays in head and neck cancer treatment lead to increased mortality, more extensive treatment and patient anxiety. We aim to treat all patients with cancer within 62 days of receipt of a referral. An analysis was conducted of those patients whose treatment had been delayed in order to identify factors associated with treatment delay.
  
  
  METHODS
  In this retrospective case-control study, 50 patients whose treatment was delayed were identified and compared with 50 patients whose treatment was not delayed. Individual factors assessed included patient age, co-morbidity, tumour location and stage, the treatment agreed, the hospitals to which the patients were referred, and the clinicians they saw.
  
  
  RESULTS
  There was a significant association between referral to a non-head and neck cancer centre, or review by a non-head and neck multidisciplinary team member, and treatment delay.
  
  
  CONCLUSIONS
  In the context of centralisation of head and neck cancer services, it is important to consider delays that may be associated with a 'hub and spoke' model of service provision.
authors: Department of Head and Neck Surgery,Charing Cross Hospital,London,UK.
authors: R
authors: R
authors: Nash
authors: Department of Head and Neck Surgery,Charing Cross Hospital,London,UK.
authors: J
authors: J
authors: Hughes
authors: Department of Histopathology,Charing Cross Hospital,London,UK.
authors: A
authors: A
authors: Sandison
authors: Department of Oncology,Charing Cross Hospital,London,UK.
authors: S
authors: S
authors: Stewart
authors: Department of Head and Neck Surgery,Charing Cross Hospital,London,UK.
authors: P
authors: P
authors: Clarke
authors: Department of Head and Neck Surgery,Charing Cross Hospital,London,UK.
authors: A
authors: A
authors: Mace
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D016022:Case-Control Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data*
keywords: Delivery Of Health Care