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

• Published in: Head & neck Vol. 27; no. 4; pp. 289 - 295
• Main Authors: Brouha, Xavier D. R., Tromp, Debbie M., de Leeuw, J. Rob J., Hordijk, Gert-Jan, Winnubst, Jacques A. M.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.04.2005; John Wiley & Sons
• Subjects: Aged; Appointments and Schedules; Attitude to Health; attribution of symptoms; Biological and medical sciences; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - psychology; Cohort Studies; Common Cold - psychology; Female; Glottis - pathology; Health Behavior; Hoarseness - psychology; Humans; Laryngeal Neoplasms - diagnosis; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - psychology; larynx cancer; Lymphatic Metastasis - pathology; Male; Medical sciences; Neoplasm Staging; Otorhinolaryngology. Stomatology; Patient Acceptance of Health Care - psychology; patient delay; tumor stage; tumor symptoms; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Voice Disorders - psychology; Human; larynx cancer; Laryngeal cancer; Stomatology; patient delay; Malignant tumor; attribution of symptoms; tumor stage; Symptomatology; tumor symptoms; Clinical stage; ENT disease; Larynx disease
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.20146

Background. The aim of this study was to determine the length of stages (appraisal, illness, behavioral, and scheduling) of patient delay in patients with head and neck cancer and to find out whether these delays were related to the stage of the disease at diagnosis. Methods. Before treatment, 117 newly diagnosed patients with laryngeal cancer were interviewed about their prediagnostic period. To determine the length of the different stages of patient delay, patients were asked about their symptoms, attributions of symptoms, and reasons to postpone medical consultation. A questionnaire was sent to the general practitioner and to a close relative to verify their answers. Results. There was no significant difference in the length of patient delay between early‐ (T1–T2) and advanced‐ stage (T3–T4) disease (9 vs 5 weeks; p = .07). Only tumor site was significantly associated with patient delay. The median total patient delays for glottic and supraglottic tumors were 10 and 4 weeks, respectively (p = .00). Hoarseness/voice change was the most commonly mentioned symptom. Patients attributed their symptom most frequently to a common cold/infection or had no idea about the cause. Medical attention was postponed because symptoms were interpreted as innocuous/benign or the symptom was thought not to be serious enough. The main reason to visit the general practitioner was persistent hoarseness. Behavioral and scheduling delays were of minor importance. Conclusions. Patient delay was significantly longer in cases of glottic cancer, but diagnosis at an early stage of the disease was more frequent among these patients than among patients with supraglottic cancer. Advanced supraglottic cancer probably has a late onset of symptoms. Thus, earlier intervention will probably not result in a significantly higher proportion of small supraglottic cancers being diagnosed. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005