An Investigation into Patient & Professional Delays in the Diagnosis of Head & Neck Cancer

Background: Head and neck cancer is a significant cause of morbidity and mortality worldwide and in Australia. Early diagnosis of this group of diseases has been shown to improve both survival and decrease morbidity. Unfortunately, a significant number of patients still present at a late stage of disease. The purpose of this study was to identify factors which may be associated with diagnostic delay in head and neck cancers. Methods: a retrospective chart review of patients who had been referred to the Multidisciplinary Head & Neck Clinic at the Newcastle Mater Misericordiae Hospital in 2004 was performed. Patients with the following disease classifications were included in the study; ID9 codes 140 -149 and 173. Forty five patients were included in the study. Patient delay and professional delay were calculated from the data. In addition referral delay (the time from the date of the referral letter to being assessed in the clinic), the biopsy delay (the period from presentation to the initial clinician to the date of biopsy) and the delay to assessment at the Head & Neck Clinic (the period from initial consultation to being seen in the clinic) were determined. Non-parametric statistical tests were used to detect an association between these five types of diagnostic delay and the following potential predictor variables; age, gender, ECOG score, presence of chronic disease(s), marital status, occupation, family history of cancer, previous diagnosis of cancer, stage of tumour at diagnosis and smoking history. Results: Disease stage at diagnosis was not associated with any of the five types of diagnostic delay examined. None of the other variables examined reached statistical significance. Conclusions: No association between 10 predictor variables and diagnostic delay in head and neck cancer were demonstrated.