An Analysis of the Timeline to Diagnosis and Treatment in Oral Cavity and Oropharynx Cancer

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVE: To estimate the time intervals from first symptom to treatment initiation and to explore the multifaceted challenges faced by patients with oral cavity and oropharynx squamous cell carcinoma (OCSCC and OPSCC) during their diagnostic journey. METHODS: A cross-sectional study was conducted with 182 patients diagnosed with OCSCC or OPSCC admitted at the São Paulo State Cancer Institute between January 2019 and November 2020. The patient interval (PI), health system diagnostic interval (HSDI), and pretreatment interval (PTI) were evaluated. RESULTS: Most patients were diagnosed at stage T3/T4 for both OCSCC (74.1%) and OPSCC (77.4%). The median PI was 1 month (IQR: 0-3), the median HSDI was 3 months (IQR: 2-6), and the median PTI was 3 months (IQR: 2-4). Patients with p16-positive OPSCC were slightly more likely to experience a longer PI (IRR = 2.38; 95% CI: 1.00-5.67; p = 0.0499). The number of healthcare services visited showed the strongest association with progressively increased HSDI. CONCLUSIONS: Sociodemographic and clinical factors were associated with variations in the duration of the interval from symptom onset to treatment initiation. Targeted interventions to streamline referral pathways, strengthen professional training, and increase awareness among high-risk populations could substantially improve timeliness of care and patient outcomes.