title: Patient-Linked Factors Associated with Delayed Reporting of Oral and Pharyngeal Carcinoma among Patients Attending National Cancer Institute, Maharagama, Sri Lanka
abstract: Background: Diagnosis of cancer at an early stage improves prognosis following treatment. Unfortunately a large
  proportion of oral and pharyngeal cancer patients are diagnosed at late stages which require radical treatment with
  considerable morbidity and mortality. Many researchers have examined different types of delay that could occur between
  the onset of symptoms and diagnosis. The objective of this research was to identify patient-linked delays between the
  time of first noticing symptoms and definitive diagnosis, and its association with the stage at diagnosis among oral
  and pharyngeal carcinoma patients attending the National Cancer Institute, Maharagama, Sri Lanka. Methods: A
  hospital-based descriptive cross-sectional study was carried out on 351 patients with histologically confirmed carcinoma
  of oral cavity and pharynx. Data were collected using an interviewer- administered questionnaire and a data extraction
  sheet. If a patient had taken more than three months to visit a Health Care Practitioner, it was considered as ‘Patient
  Delay-1’. If a patient had taken more than two weeks following referral to reach for specialized cancer care, it was
  considered as ‘Patient Delay 2’. Results: Proportions of ‘Patient Delay-1’ and ‘Patient Delay-2’ were 19% (n=252)
  and 16% (n=322) respectively. Mean time duration between noticing symptoms to definitive diagnosis was 14.1
  weeks (SD=10.3). The proportion of advanced-stage cancers at diagnosis was 59.8%. Conclusion: Stage at diagnosis
  was significantly associated with ‘Patient Delay -1’ (p = 0.001) but not with ‘Patient Delay-2’. ‘Patient Delay-1’ was
  significantly associated with level of education (p = 0.001) and the cost of travelling (p = 0.048).
authors.affiliation: Dental Surgeon, Oral Cancer Department, National Cancer Control Programme, Ministry of Health, Sri Lanka. Email:shreeni2009@yahoo.com
authors.forename: Laurence Shreenikumari
authors.lastname: Alahapperuma
authors.forename: Eshani Anoja
authors.initials: EA
authors.lastname: Fernando
keywords: Early detection of cancer; buccal cavity neoplasms; pharyngeal neoplasms; Primary Health Care