title: Key points and time intervals for early diagnosis in symptomatic oral cancer: a systematic review.
abstract: The aim of this study was to identify key points and time intervals in the patient pathway to the diagnosis of oral cancer, from the detection of a bodily change to the start of treatment. A systematic search of three databases was performed by two researchers independently. Articles reporting original data on patients with symptomatic primary oral or oropharyngeal squamous cell carcinoma that was pathologically confirmed were included. These articles had to include an outcome variable of 'diagnostic delay', 'time interval', or 'waiting time to diagnosis', or report time intervals from first symptom to treatment. Furthermore, the outcome variable had to have a clearly defined start point and end point, with the time measurement presented as a continuous or categorical variable. A total of 1175 reports were identified; 28 articles on oral cancer studies and 13 on oral and oropharyngeal cancer studies were finally included. These papers showed poor quality in terms of questionnaire validation, acknowledgement of biases influencing time-point measurements, and strategies for verification of patient self-reported data. They also showed great heterogeneity. The review findings allowed the definition of key points and time intervals within the Aarhus framework that may better suit the features of the diagnostic process of this neoplasm, particularly when assessing the impact of waiting time to diagnosis.
authors.affiliation: Galician Health Service, EOXI Lugo, Cervo e Monforte, Lugo, Spain; Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: P
authors.initials: P
authors.lastname: Varela-Centelles
authors.affiliation: Service of Oral and Maxillofacial Surgery, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: López-Cedrún
authors.affiliation: Service of Oral and Maxillofacial Surgery, Povisa Hospital, Vigo (Pontevedra), Spain.
authors.forename: J
authors.initials: J
authors.lastname: Fernández-Sanromán
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Seoane-Romero
authors.affiliation: Departamento de Odontologia, Faculdade de Ciências da Saúde, Universidade de Brasília, Campus Universitário, Asa Norte, Brasília DF, Brazil.
authors.forename: N
authors.initials: N
authors.lastname: Santos de Melo
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: P
authors.initials: P
authors.lastname: Álvarez-Nóvoa
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
authors.forename: I
authors.initials: I
authors.lastname: Gómez
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain. Electronic address: juanmanuel.seoane@usc.es.
authors.forename: J
authors.initials: J
authors.lastname: Seoane
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy; D057210:Delayed Diagnosis; D055088:Early Detection of Cancer; D006801:Humans; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000628:therapy; D013997:Time Factors; D061665:Time-to-Treatment
keywords: Aarhus statement; Andersen model; diagnostic delay; oral cancer; oral squamous cell carcinoma; oropharyngeal cancer; time intervals