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Factors Associated with Delay in the Diagnosis of Oral Cancer

¹ Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, 188 Longwood Ave., Boston, MA 02115, USA;
² Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA;
³ Department of Community Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen 40002, Thailand;
⁴ Craniofacial Epidemiology and Genetics Branch, National Institute of Dental and Craniofacial Research, Bethesda, MD 20892-6401, USA; and
⁵ Oral Medicine Department, A. Sygros Hospital, University of Athens Medical School, 37 Ipsiladou Street, Athens 10676, Greece;

*corresponding author, zavras{at}hms.harvard.edu

Early detection and treatment improve the prognosis for oral cancer. Delays from the onset of symptoms to clinical diagnosis are common. Our aim is to identify factors associated with this delay. Between 1995 and 1998, we interviewed 105 consecutive patients with histologically confirmed oral cancer in Greece. If 21 or more days elapsed from the time the patient noticed major symptoms to a definitive diagnosis, we called it a delay (52% of cases). We used logistic and linear regression to estimate odds ratios of delayed diagnosis and to identify correlates of length of delay, respectively. Former smokers had a 4.3 times greater risk of delayed diagnosis compared with current smokers (95% confidence interval: 1.1-17.1). The length of delay was greater among single patients, non-smokers, or those with stage IV tumors. Clinicians should be advised that delay in the diagnosis of oral cancer occurs frequently, even in individuals who do not smoke heavily.

KEY WORDS: diagnosis • delay • oral cavity • mouth neoplasms

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