Diagnostic Pathway of Oral Cavity Cancer in an Integrated Health Care System

Wang, Kevin H.; Song, Bofan; Gilde, Jason; Darbinian, Jeanne; Weintraub, Miranda Ritterman; Wu, Tara J; Yang, Eunjin; Salazar, James W.; Gurushanthaiah, Deepak

doi:10.7812/tpp/17-152

Cited by 15 publications

(13 citation statements)

References 23 publications

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“…Access to health services, appointments, usage of public transportation, cultural and social backgrounds maybe additional explanations for a larger interval ( 5 , 7 ). Although some studies ( 8 , 24 - 26 ) report that patient interval is the most significant contributor to delay in the diagnosis, in our study both patient and professional compromised the total interval. Interestingly, some authors have described lower professional intervals in advanced malignancies that should be interpreted as a bias of urgent care and taken into account for future studies regarding the interval from diagnosis to treatment.…”

Section: Discussioncontrasting

confidence: 58%

The interval since first symptoms until diagnosis of squamous cell carcinoma in the head and neck region is still a problem in southern Brazil

Lb¹,

Rt²,

Lm³

et al. 2020

Med Oral

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Background The aim was to examine the interval since first symptoms until final diagnosis of squamous cell carcinoma (SCC) in the head and neck region in southern Brazil. Material and Methods The individuals were prospectively selected and underwent anamnesis, physical examination and interview in the first medical consultation at a Cancer Hospital from south of Brazil. Results From 488 patients who underwent clinical examination, 105 were included in the study with diagnosis of SCC. Patients average interval from first symptoms to final diagnosis was 152 days (median 86; max:1105; min: 1), the average professional interval was 108 days (median: 97; max:525; min: 1) , and the average total period interval was 258 days (median: 186; max:1177; min: 45). Factors statistically associated with patient and diagnosis itinerary intervals were smoking and poorly adapted dentures and distance from home to hospital, respectively. Conclusions The identification of the itinerary characteristics of this specific population may reflect in more effective public policies, such as primary and secondary prevention programs, aiming to increase the survival of oncological patient. Furthermore, the knowledge of the variables that influence the late diagnosis minimizes patient's journey in search of care to cancer centers through health programs. Key words: Head and neck cancer, time interval, time to diagnosis, diagnosis delay, squamous cell carcinoma.

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Section: Discussioncontrasting

confidence: 58%

The interval since first symptoms until diagnosis of squamous cell carcinoma in the head and neck region is still a problem in southern Brazil

Lb¹,

Rt²,

Lm³

et al. 2020

Med Oral

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“…Diagnostic dilemmas have been identified in various areas of otolaryngology. In oral cavity cancer 21 and oropharyngeal squamous cell carcinoma, 19,20 diagnostic delays lead to poor outcomes and decreased survival. The dilemma is evident in chronic sinusitis, in which the symptoms overlap with other common conditions, including allergic rhinitis and viral upper respiratory tract infection 30 .…”

Section: Discussionmentioning

confidence: 99%

“…In a series of 15 patients, 80% of patients who did not undergo aspirin desensitization required revision surgery 10 . Other studies in otolaryngology on oropharyngeal squamous cell carcinoma, 19,20 oral cavity cancer, 21 and laryngeal lesions 22 have also shown that diagnostic delay can lead to poor clinical outcomes. We aimed to describe a large cohort of AERD patients to further understand disease course, identify whether there is clinical diagnostic delay, and investigate whether diagnostic patterns contribute to clinical outcomes.…”

mentioning

confidence: 99%

Aspirin‐exacerbated respiratory disease: longitudinal assessment of a large cohort and implications of diagnostic delay

Kshirsagar

Chou

Wei

et al. 2020

Int Forum Allergy Rhinol

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Background Aspirin‐exacerbated respiratory disease (AERD) refers to the combination of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and acute respiratory tract reactions to ingestion of aspirin and nonsteroidal anti‐inflammatory drugs (NSAIDs). There have been no in the literature investigating diagnostic delay in AERD. We aimed to investigate whether delay of diagnosis of AERD is associated with poorer clinical outcomes as well as to characterize the role of specialty evaluation in diagnosis. Methods We conducted a retrospective observational study of 254 subjects with incident AERD diagnoses between 2009 and 2016 among Kaiser Permanente Northern California (KPNC) members. Descriptive and bivariate statistics were employed to analyze clinical characteristics and outcomes of AERD subjects with and without delay in diagnosis (defined as 1 year or greater from symptom onset to diagnosis). Results Of the 254 patients in the AERD cohort, 24.4% had a delayed diagnosis. Patients with allergies were significantly less likely to have a delay in diagnosis (p < 0.01). Patients with a delay in diagnosis were more likely to have 2 or more courses of systemic steroids (p = 0.04). Allergists, otolaryngologists, and primary care physicians diagnosed 56%, 36%, and 8% of patients, respectively. There was no association between provider specialty at time of diagnosis and delay in diagnosis (p = 0.22). Conclusion A substantial proportion of AERD patients have a diagnostic delay. Patients with allergies have a lower risk for this delay. This study is the first to describe diagnostic delay in AERD patients.

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“…Many types of oral lesions have malignant transformation potential, aptly named premalignant or precancerous lesions. Premalignant lesions are described by using clinical, pathological, histochemical, and also many other screening techniques for which lesions such as leukoplakia, lichen planus with oral and cutaneous form, erythroplakia, stomatitis nicotina, and submucous fibrosis are named or classified [3,10,15,18,22,[33][34][35]. In addition, there is less malign transformation potential in lesions such as discoid lupus erythematosus and also a lesser likelihood of malignant transformation in hereditary entities such as epidermolysis bullosa and dyskeratosis congenita [34].…”

Section: Look and See: Precancerous Mouth Lesionsmentioning

confidence: 99%

Early Detection and Multidisciplinary Approach to Oral Cancer Patients

Akbulut¹,

Altan²

2019

Prevention, Detection and Management of Oral Cancer

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"Oral cancer" is a term usually describing oral cavity and oropharyngeal malign tumors. The most histologic type of carcinoma is squamous cell carcinoma, seen in oral and oropharyngeal region with the incidence of 90%. Prevention or early diagnosis of premalignant and oral cancer requires increased public awareness and educating practitioners to be skillful in identifying oropharyngeal region pathology. To prevent oral cancers, the etiological factors should be known, and measures must be taken according to those factors. Premalignant lesions are leukoplakia, lichen planus in oral and cutaneous form, erythroplakia, stomatitis nicotina, and submucous fibrosis. Premalignant lesions should be treated, if possible, or followed up on carefully. To date, there are many clinical, histopathological, radiological, and optical techniques to diagnose or capture precancerous and oral cancer lesions early. The routine management of oral cancers is firstly surgical resection with or without postoperative adjuncts and other therapies such as the use of postoperative chemoradiation and radiation. Successful treatment of oral cancer patients is a complex issue that requires a multidisciplinary approach, including oral and maxillofacial surgeons, oral and maxillofacial radiologists, ENT specialists, medical and radiological oncologists, prosthodontists, dentists, speech therapists, supportive care experts, and also pathologists or, if possible, oral and maxillofacial pathologists.

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Diagnostic Pathway of Oral Cavity Cancer in an Integrated Health Care System

Cited by 15 publications

References 23 publications

The interval since first symptoms until diagnosis of squamous cell carcinoma in the head and neck region is still a problem in southern Brazil

The interval since first symptoms until diagnosis of squamous cell carcinoma in the head and neck region is still a problem in southern Brazil

Aspirin‐exacerbated respiratory disease: longitudinal assessment of a large cohort and implications of diagnostic delay

Early Detection and Multidisciplinary Approach to Oral Cancer Patients

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