Delay in Diagnosis and Treatment of Squamous Cell Carcinoma of the Skin

• Published in: Acta dermato-venereologica Vol. 90; no. 6; pp. 595 - 601
• Main Authors: RENZI, Cristina, MASTROENI, Simona, MANNOORANPARAMPIL, Thomas J, PASSARELLI, Francesca, CAGGIATI, Alessio, POTENZA, Clemente, PASQUINI, Paolo
• Format: Journal Article
• Language: English
• Published: Uppsala Acta dermato-venereologica 01.01.2010
• Subjects: Aged; Biological and medical sciences; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - psychology; Carcinoma, Squamous Cell - therapy; Chi-Square Distribution; Delayed Diagnosis; Dermatology; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Italy; Logistic Models; Male; Medical sciences; Middle Aged; Odds Ratio; Patient Acceptance of Health Care; Risk Assessment; Risk Factors; Skin Neoplasms - diagnosis; Skin Neoplasms - psychology; Skin Neoplasms - therapy; Time Factors; Treatment Outcome; Tumors of the skin and soft tissue. Premalignant lesions; Italy; cutaneous; Skin disease; Squamous cell carcinoma; Basal cell carcinoma; Treatment; delay; Dermatology; Skin; Malignant tumor; Diagnosis; Cancer; Skin cancer
• ISSN: 0001-5555; 1651-2057
• DOI: 10.2340/00015555-0966

Advanced squamous cell carcinomas (SCC) of the skin can cause significant tissue destruction and may metastasize. Understanding the determinants of patient delay could help prevent advanced presentation. The purpose of the present study was to examine patient- and healthcare-related factors associated with delay before the detection and treatment of SCC. A sample of 308 patients with SCC treated at a dermatological referral centre in Italy were interviewed. Clinical data were obtained from the medical records. The highest quartile patients reported > 9 months delay between noticing the lesion and the first medical visit (defined as long patient delay). Multivariate analysis showed that SCC arising on pre-existing chronic lesions were associated with long patient delay (odds ratio = 3.17; 95% confidence interval 1.1-9.3). Controlling for confounders, the first physician's advice to remove the lesion immediately was associated with a shorter treatment delay (p < 0.001). In conclusion, our work emphasizes the importance of seeing a doctor about any change in a pre-existing lesion, particularly in light of the fact that SCC on chronic lesions are at greater risk of metastasis and recurrence.