From neglect to earlier diagnosis: a qualitative meta-synthesis of psycho-social factors associated with consultation delay in advanced basal cell carcinoma

Legrand, Anthony; Quintard, Bruno; Garrouteigt, Constance; Beylot‐Barry, M.; Broc, Guillaume

doi:10.1080/13548506.2021.1952281

Cited by 3 publications

(2 citation statements)

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“…Some studies also suggest that certain psychological factors may contribute to development of locally advanced NMSCs 39 . These may include fear ormistrust of medical intervention, denial of disease, and low social milieu 19,40 .…”

Section: Discussionmentioning

confidence: 99%

“…Some studies also suggest that certain psychological factors may contribute to development of locally advanced NMSCs. 39 These may include fear ormistrust of medical intervention, denial of disease, and low social milieu. 19,40 Our study was unable to evaluate these factors within the context of a retrospective study, although we do show that homelessness is associated with higher disease stage at presentation.…”

Section: Discussionmentioning

confidence: 99%

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Insurance Status is Associated With Recurrence in Cutaneous Head and Neck Squamous Cell Carcinoma

Victor,

Zheng,

Park

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo identify socioeconomic factors influencing the presentation and outcomes of cutaneous head and neck squamous cell carcinoma (cHNSCC).Study DesignRetrospective cohort study.SettingTertiary academic medical center with comprehensive cancer center.MethodsPatients treated for cHNSCC at a single institution between 2008 and 2022 were included. Demographic, socioeconomic data and disease characteristics were obtained from medical record abstraction. Outcome measures included tumor stage, number of distinct primaries, recurrence, and disease‐related death. χ2 and Mann‐Whitney tests were implemented to evaluate clinicopathologic distributions across disease stages. Survival analyses were performed using Cox regression and Kaplan‐Meier analysis.ResultsA total of 346 patients met the inclusion criteria. The median age at presentation and length of follow‐up was 70.8 and 3.1 years, respectively. The majority of the cohort was white, male, and English‐speaking. 13.3% of patients were underinsured and 27.5% were immunosuppressed. Patients who presented with advanced disease were more likely to be underinsured (21.7% vs 9.6%, P = .006) and have a history of homelessness (8.5% vs 2.1%, P = .014). Immunosuppressed patients were more likely to be underinsured (P = .009). Insurance status (1.97 [1.06‐3.66], P = .032) and immune status (2.35 [1.30‐4.26], P = .005) were independently associated with worse recurrence‐free survival.ConclusionSocioeconomic factors that influence access to care, such as insurance status, are associated with cHNSCC disease stage and disease recurrence. These factors may impose barriers that delay diagnosis and treatment. This may result in worse disease‐related outcomes and greater treatment‐associated morbidity for certain patients.

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Section: Discussionmentioning

confidence: 99%