Laryngeal cancer patients: Analysis of patient delay at different tumor stages

Brouha, X.D.R.; Tromp, D.M.; Leeuw, J.R.J. de; Hordijk, G. J.; Winnubst, J.A.M.

doi:10.1002/hed.20146

Cited by 47 publications

(74 citation statements)

References 18 publications

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“…Several studies indicate that the worsening and progression of symptoms is a main factor prompting consultation in primary care, 10,27,32,34 and in many cases the patient attributed these symptoms to mild benign illness. 27,34 In addition, the propensity to seek help for health-related matters varies across people, 43 which likely explains some of the patientrelated delay that has been observed, and health-related lay social networks can vary in quality, thereby influencing a patient's decision to seek a professional opinion about symptoms. 44 The practice of studying populations of patients whose cancers are from across the spectrum of head and neck sites likely undermines the ability to observe an association between diagnostic delay and stage, as symptoms and tumor biology vary among these sites.…”

Section: Discussionmentioning

confidence: 98%

“…Provider delay Teppo et al 33 ; Brouha et al 34 *Relationship suggested only; no statistical testing done or relationship only approached significance (P < .10).…”

Section: Patient Delaymentioning

confidence: 96%

“…Brouha et al 34 found no relationship between patient delay and stage for oropharyngeal cancers. Koinuven et al 29 found no relationship between either patient or provider delays >2 months and stage at diagnosis in multivariate analysis of pharyngeal cancers at all sites.…”

Section: Diagnostic Delay and Stage At Diagnosis For Pharyngeal Cancersmentioning

confidence: 98%

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Diagnostic delay and disease stage in head and neck cancer: A systematic review

et al. 2009

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Possible explanations for the lack of an observed relationship between patient delay and stage include: inaccurate measurement of delay, lack of sensitivity of disease stage to delay-related disease progression, and variation in tumor aggressiveness, which could lead to variation in symptom progression rates. We call for better evidence about the relationship between diagnostic delay and disease progression and/or disease outcomes. If demonstrated and validated, such associations would provide a much stronger argument than description of delay alone for education programs around symptom recognition and for more active screening of high-risk individuals.

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Section: Discussionmentioning

confidence: 98%

“…Provider delay Teppo et al 33 ; Brouha et al 34 *Relationship suggested only; no statistical testing done or relationship only approached significance (P < .10).…”

Section: Patient Delaymentioning

confidence: 96%

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Diagnostic delay and disease stage in head and neck cancer: A systematic review

et al. 2009

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“…As a result, all patients were diagnosed with an advanced stage of the disease accompanied by enlarged lymph nodes in the neck. The misinterpretation of cancer symptoms is a problem that has been reported elsewhere [24, 25]. Additionally, patients were not aware of the consequences of a delay in diagnosis.…”

Section: Discussionmentioning

confidence: 99%

The role of Indonesian patients’ health behaviors in delaying the diagnosis of nasopharyngeal carcinoma

et al. 2017

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BackgroundWith an estimated 13,000 newly diagnosed patients per year, nasopharyngeal carcinoma (NPC) is one of the most common types of cancer in males in Indonesia. Moreover, most patients are diagnosed at an advanced stage of the disease. This study aimed to explore the health behaviors of patients diagnosed with NPC and the possible causes of patient delay in NPC diagnosis.MethodsA qualitative research method was used to gain better insight into patient behaviors. Twelve patients were interviewed using semi-structured interview guidelines. All interviews were recorded, transcribed verbatim and analyzed according to a standard content analysis framework.ResultsMost patients had limited knowledge regarding NPC and its causes. Fifty percent of the patients had a delay of six months from the onset of symptoms to diagnosis. The main reason for this delay was the lack of awareness among the patients, which was influenced by their environment, economic status, family, culture, and religion. The perceived barriers to seeking medical help included direct non-medical costs not covered by health insurance, complex and time-consuming insurance and referral systems, and negative experiences in the past. Health insurance did motivate people to seek medical help.ConclusionThis study provides additional insight into patients’ motivations to delay seeking medical help and can facilitate the design of NPC education programs. To improve awareness of the abovementioned causes for delay, community-based education programs are highly warranted and should focus on the recognition of NPC symptoms and possible solutions to overcome the main barriers at an earlier disease stage.

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“…4 There are both benign and malignant factors that can cause dysphonia, but what is concerning is that up to 52% of patients with laryngeal cancer thought their hoarseness was harmless, leading to a delay in evaluation and treatment. 5 The guidelines list comorbidities that should trigger a patient and clinician to suspect a serious underlying cause of the dysphonia (Box 1). This article builds on the invaluable article by Blitzer, elsewhere in this issue, regarding laryngeal anatomy and function, and presents a laryngologist's focus on the different tools, highlights, and pitfalls in the evaluation of the dysphonic patient.…”

mentioning

confidence: 99%