Impact of the Presenting Symptom on Time Intervals and Diagnostic Routes of Patients with Symptomatic Oral Cancer
This investigation was aimed at determining the time intervals from the presenting symptoms until the beginning of oral cancer treatment and their relative contribution to the total time, and to assess the impact of the presenting symptom on diagnostic timelines and patient referral routes. A cross-...
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| Published in | Cancers Vol. 13; no. 20; p. 5163 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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14.10.2021
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| Abstract | This investigation was aimed at determining the time intervals from the presenting symptoms until the beginning of oral cancer treatment and their relative contribution to the total time, and to assess the impact of the presenting symptom on diagnostic timelines and patient referral routes. A cross-sectional, ambispective study was designed to investigate symptomatic incident cases. The Aarhus statement was used as a conceptual framework. Strategies for minimizing potential recall biases were implemented. A sample of 181 patients was recruited (power: 99.5%; α = 0.05). The patient interval reached 58.2 days (95% CI, 40.3–76.2), which accounted for 74% of the whole prereferral interval and for more than one third of the total time interval. The presenting symptom (trigger for consultation) influenced both the number of primary care consultations and the length of time to diagnosis. General dental practitioners generated longer intervals to diagnosis (p < 0.005) and needed more consultations before referring a patient (RR = 0.76; 95% CI, 0.61–0.93), than general medical practitioners. The current study identifies the patient as the main target for interventions to improve awareness and reinforces the need for increased alertness amongst healthcare professionals about presenting symptoms of oral cancer and to diminish the number of prereferral consultations in order to optimize the primary care interval. |
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| AbstractList | This investigation was aimed at determining the time intervals from the presenting symptoms until the beginning of oral cancer treatment and their relative contribution to the total time, and to assess the impact of the presenting symptom on diagnostic timelines and patient referral routes. A cross-sectional, ambispective study was designed to investigate symptomatic incident cases. The Aarhus statement was used as a conceptual framework. Strategies for minimizing potential recall biases were implemented. A sample of 181 patients was recruited (power: 99.5%; α = 0.05). The patient interval reached 58.2 days (95% CI, 40.3–76.2), which accounted for 74% of the whole prereferral interval and for more than one third of the total time interval. The presenting symptom (trigger for consultation) influenced both the number of primary care consultations and the length of time to diagnosis. General dental practitioners generated longer intervals to diagnosis (p < 0.005) and needed more consultations before referring a patient (RR = 0.76; 95% CI, 0.61–0.93), than general medical practitioners. The current study identifies the patient as the main target for interventions to improve awareness and reinforces the need for increased alertness amongst healthcare professionals about presenting symptoms of oral cancer and to diminish the number of prereferral consultations in order to optimize the primary care interval. Simple SummaryInformation about the relative length of patient stays, primary care, and prereferral intervals (from symptom onset to specialist referral) is very scarce, and how the presenting symptoms influence these intervals and referral routes remains unknown. This study assesses the impact of presenting symptoms on time intervals, number of visits at the primary care level, and referral pattern of patients with symptomatic oral cancer. This approach will allow targets to be identified for future interventions and the optimization of the treatment pathway for symptomatic oral cancer patients.AbstractThis investigation was aimed at determining the time intervals from the presenting symptoms until the beginning of oral cancer treatment and their relative contribution to the total time, and to assess the impact of the presenting symptom on diagnostic timelines and patient referral routes. A cross-sectional, ambispective study was designed to investigate symptomatic incident cases. The Aarhus statement was used as a conceptual framework. Strategies for minimizing potential recall biases were implemented. A sample of 181 patients was recruited (power: 99.5%; α = 0.05). The patient interval reached 58.2 days (95% CI, 40.3–76.2), which accounted for 74% of the whole prereferral interval and for more than one third of the total time interval. The presenting symptom (trigger for consultation) influenced both the number of primary care consultations and the length of time to diagnosis. General dental practitioners generated longer intervals to diagnosis (p < 0.005) and needed more consultations before referring a patient (RR = 0.76; 95% CI, 0.61–0.93), than general medical practitioners. The current study identifies the patient as the main target for interventions to improve awareness and reinforces the need for increased alertness amongst healthcare professionals about presenting symptoms of oral cancer and to diminish the number of prereferral consultations in order to optimize the primary care interval. |
| Author | García-Rozado, Álvaro Varela-Centelles, Pablo Ignacio Baz, Pablo Castelo López, Daniel Pérez Romero-Méndez, Amparo Seoane, Juan López-Cedrún, José Luis |
| AuthorAffiliation | 1 Department of Surgery and Medical-Surgical Specialities, Medical & Dental School, University of Santiago de Compostela, Entrerríos s/n, 15705 Santiago de Compostela, Spain; pabloignacio.varela@usc.es (P.I.V.-C.); daniel.perez.lopez@rai.usc.es (D.P.L.); pablo.castelo.baz@usc.es (P.C.B.); mariaamparo.romero@usc.es (A.R.-M.) 2 Service of Oral and Maxillofacial Surgery, A Coruña University Hospital (CHUAC), Xubias-84, 15006 A Coruña, Spain; jose.lopez.cedrun@sergas.es (J.L.L.-C.); Alvaro.Garcia-Rozado.Gonzalez@sergas.es (Á.G.-R.) |
| AuthorAffiliation_xml | – name: 2 Service of Oral and Maxillofacial Surgery, A Coruña University Hospital (CHUAC), Xubias-84, 15006 A Coruña, Spain; jose.lopez.cedrun@sergas.es (J.L.L.-C.); Alvaro.Garcia-Rozado.Gonzalez@sergas.es (Á.G.-R.) – name: 1 Department of Surgery and Medical-Surgical Specialities, Medical & Dental School, University of Santiago de Compostela, Entrerríos s/n, 15705 Santiago de Compostela, Spain; pabloignacio.varela@usc.es (P.I.V.-C.); daniel.perez.lopez@rai.usc.es (D.P.L.); pablo.castelo.baz@usc.es (P.C.B.); mariaamparo.romero@usc.es (A.R.-M.) |
| Author_xml | – sequence: 1 givenname: Pablo Ignacio surname: Varela-Centelles fullname: Varela-Centelles, Pablo Ignacio – sequence: 2 givenname: Daniel Pérez surname: López fullname: López, Daniel Pérez – sequence: 3 givenname: José Luis surname: López-Cedrún fullname: López-Cedrún, José Luis – sequence: 4 givenname: Álvaro surname: García-Rozado fullname: García-Rozado, Álvaro – sequence: 5 givenname: Pablo Castelo surname: Baz fullname: Baz, Pablo Castelo – sequence: 6 givenname: Amparo surname: Romero-Méndez fullname: Romero-Méndez, Amparo – sequence: 7 givenname: Juan orcidid: 0000-0003-4751-591X surname: Seoane fullname: Seoane, Juan |
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| CitedBy_id | crossref_primary_10_3389_fpubh_2023_1183244 crossref_primary_10_1016_j_ijnurstu_2023_104466 crossref_primary_10_1002_ccr3_8994 crossref_primary_10_7759_cureus_55715 crossref_primary_10_3390_cancers14071758 crossref_primary_10_1186_s12913_023_09437_0 |
| Cites_doi | 10.1111/coa.12919 10.1111/ecc.13207 10.1186/s12875-021-01480-2 10.1016/j.oraloncology.2008.06.002 10.1016/j.oraloncology.2006.08.001 10.1136/bmj.g7400 10.1111/j.1749-4486.2012.02464.x 10.1053/joms.2003.50056 10.1016/j.ijom.2016.09.017 10.1111/j.1749-4486.2008.01704.x 10.1001/jamaoto.2018.2716 10.1111/odi.13362 10.1016/S1368-8375(00)00067-1 10.17219/acem/116753 10.1038/bjc.2012.68 10.1111/j.1600-0722.2009.00672.x 10.1186/1472-6963-9-189 10.3399/bjgp11X613160 10.1016/0964-1955(92)90007-N 10.1371/journal.pone.0224067 10.1016/j.neo.2017.11.005 10.1002/hed.24050 10.1001/jamaoto.2014.867 10.1111/j.1600-0714.2007.00547.x 10.1038/bjc.2015.40 10.3399/bjgp18X700205 10.1016/S1368-8375(00)00066-X 10.1016/j.bjoms.2020.06.009 10.4103/0019-509X.137934 10.1016/S0266-4356(97)90679-3 10.1016/S1470-2045(12)70041-4 10.1200/GO.20.00310 10.1177/0022034511402082 10.1038/bjc.2015.48 10.1016/S1368-8375(03)00075-7 10.1136/bmj.i6784 10.1002/1097-0142(20011201)92:11<2885::AID-CNCR10119>3.0.CO;2-G 10.1038/bjc.2013.1 10.1111/adj.12314 10.1002/hed.21338 10.1002/ijc.32871 10.1007/s13187-010-0045-6 10.1016/j.oraloncology.2010.02.015 10.1002/hed.20270 10.1111/j.2044-8287.2012.02077.x 10.14219/jada.archive.2008.0046 |
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| References | Koivunen (ref_18) 2001; 92 Brakenhoff (ref_40) 2011; 16 Lyratzopoulos (ref_15) 2015; 112 Lyratzopoulos (ref_48) 2014; 349 Sargeran (ref_31) 2009; 7 Seoane (ref_10) 2009; 117 Kantola (ref_19) 2001; 51 Dhanuthai (ref_4) 2018; 23 Morelatto (ref_37) 2007; 36 ref_53 Seoane (ref_25) 2018; 43 Brouha (ref_29) 2005; 27 Onizawa (ref_45) 2003; 39 Warnakulasuriya (ref_6) 2009; 45 Seoane (ref_14) 2016; 38 Peacock (ref_30) 2008; 139 Holmes (ref_44) 2003; 61 Lyratzopoulos (ref_55) 2012; 13 Kaing (ref_36) 2016; 61 Joshi (ref_35) 2014; 51 Neal (ref_9) 2015; 112 Jovanovic (ref_32) 1992; 28 Seoane (ref_11) 2012; 37 Mansell (ref_51) 2011; 61 ref_21 Koo (ref_52) 2021; 7 ref_27 Yeung (ref_54) 2017; 356 Graboyes (ref_16) 2019; 145 Lyratzopoulos (ref_22) 2013; 108 Koo (ref_26) 2018; 20 Dimitroulis (ref_42) 1992; 28 Rutkowska (ref_24) 2020; 29 Seoane (ref_13) 2017; 46 Teppo (ref_17) 2008; 33 Weller (ref_12) 2012; 106 Luryi (ref_50) 2014; 140 ref_33 Pinholt (ref_43) 1997; 35 Arduino (ref_28) 2021; 27 ref_39 Rogers (ref_34) 2007; 43 Warnakulasuriya (ref_7) 2010; 46 Silverman (ref_8) 2010; 25 Seoane (ref_47) 2020; 25 Scott (ref_41) 2013; 18 Jonhson (ref_5) 2011; 23 Kowalski (ref_38) 2001; 37 Langton (ref_49) 2020; 58 Bosetti (ref_2) 2020; 147 ref_1 Kerdpon (ref_46) 2001; 37 Chen (ref_23) 2019; 69 Seoane (ref_20) 2010; 32 Shrestha (ref_3) 2020; 29 |
| References_xml | – volume: 43 start-page: 164 year: 2018 ident: ref_25 article-title: The length of patient and primary care time interval in the pathways to treatment in symptomatic oral cancer. A quantitative systematic review publication-title: Clin. Otolaryngol. doi: 10.1111/coa.12919 contributor: fullname: Seoane – volume: 29 start-page: e13207 year: 2020 ident: ref_3 article-title: Prevalence and incidence of oral cancer in low- and middle-income countries: A scoping review publication-title: Eur. J. Cancer Care Engl. doi: 10.1111/ecc.13207 contributor: fullname: Shrestha – ident: ref_53 doi: 10.1186/s12875-021-01480-2 – volume: 45 start-page: 309 year: 2009 ident: ref_6 article-title: Global epidemiology of oral and oropharyngeal cancer publication-title: Oral Oncol. doi: 10.1016/j.oraloncology.2008.06.002 contributor: fullname: Warnakulasuriya – volume: 43 start-page: 648 year: 2007 ident: ref_34 article-title: An assessment of deprivation as a factor in the delays in presentation, diagnosis and treatment in patients with oral and oropharyngeal squamous cell carcinoma publication-title: Oral Oncol. doi: 10.1016/j.oraloncology.2006.08.001 contributor: fullname: Rogers – volume: 349 start-page: g7400 year: 2014 ident: ref_48 article-title: Rethinking diagnostic delay in cancer: How difficult is the diagnosis? publication-title: BMJ doi: 10.1136/bmj.g7400 contributor: fullname: Lyratzopoulos – ident: ref_39 – volume: 37 start-page: 99 year: 2012 ident: ref_11 article-title: Impact of delay in diagnosis on survival to head and neck carcinomas: A systematic review with meta-analysis publication-title: Clin. Otolaryngol. doi: 10.1111/j.1749-4486.2012.02464.x contributor: fullname: Seoane – volume: 61 start-page: 285 year: 2003 ident: ref_44 article-title: Is detection of oral and oropharyngeal squamous cancer by a dental health care provider associated with a lower stage at diagnosis? publication-title: J. Oral Maxillofac. Surg. doi: 10.1053/joms.2003.50056 contributor: fullname: Holmes – ident: ref_1 – volume: 46 start-page: 1 year: 2017 ident: ref_13 article-title: Key points and time intervals for early diagnosis in symptomatic oral cancer: A systematic review publication-title: Int. J. Oral Maxillofac. Surg. doi: 10.1016/j.ijom.2016.09.017 contributor: fullname: Seoane – volume: 28 start-page: 37 year: 1992 ident: ref_32 article-title: Delay in diagnosis of oral squamous cell carcinoma; a report from the Netherlands publication-title: Oral Oncol. contributor: fullname: Jovanovic – volume: 33 start-page: 325 year: 2008 ident: ref_17 article-title: Relative importance of diagnostic delays in different head and neck cancers publication-title: Clin. Otolaryngol. doi: 10.1111/j.1749-4486.2008.01704.x contributor: fullname: Teppo – volume: 145 start-page: 166 year: 2019 ident: ref_16 article-title: Association of Treatment Delays With Survival for Patients With Head and Neck Cancer: A Systematic Review publication-title: JAMA Otolaryngol. Head Neck Surg. doi: 10.1001/jamaoto.2018.2716 contributor: fullname: Graboyes – volume: 27 start-page: 742 year: 2021 ident: ref_28 article-title: The outbreak of Novel Coronavirus disease (COVID-19) caused a worrying delay in the diagnosis of oral cancer in north-west Italy: The Turin Metropolitan Area experience publication-title: Oral Dis. doi: 10.1111/odi.13362 contributor: fullname: Arduino – volume: 37 start-page: 216 year: 2001 ident: ref_46 article-title: Factors related to advanced stage oral squamous cell carcinoma in southern Thailand publication-title: Oral Oncol. doi: 10.1016/S1368-8375(00)00067-1 contributor: fullname: Kerdpon – volume: 29 start-page: 735 year: 2020 ident: ref_24 article-title: Oral cancer: The first symptoms and reasons for delaying correct diagnosis and appropriate treatment publication-title: Adv. Clin. Exp. Med. doi: 10.17219/acem/116753 contributor: fullname: Rutkowska – ident: ref_27 – volume: 106 start-page: 1262 year: 2012 ident: ref_12 article-title: The Aarhus statement: Improving design and reporting of studies on early cancer diagnosis publication-title: Br. J. Cancer doi: 10.1038/bjc.2012.68 contributor: fullname: Weller – volume: 117 start-page: 541 year: 2009 ident: ref_10 article-title: Is diagnostic delay related to advanced-stage oral cancer? A meta-analysis publication-title: Eur. J. Oral Sci. doi: 10.1111/j.1600-0722.2009.00672.x contributor: fullname: Seoane – volume: 25 start-page: e455 year: 2020 ident: ref_47 article-title: People would rather see a physician than a dentist when experiencing a long-standing oral ulceration. A population-based study in Spain publication-title: Med. Oral Patol. Y Oral Cir. Bucal contributor: fullname: Seoane – ident: ref_33 doi: 10.1186/1472-6963-9-189 – volume: 61 start-page: e821 year: 2011 ident: ref_51 article-title: Interventions to reduce primary care delay in cancer referral: A systematic review publication-title: Br. J. Gen. Pract. doi: 10.3399/bjgp11X613160 contributor: fullname: Mansell – volume: 28 start-page: 23 year: 1992 ident: ref_42 article-title: Referral patterns of patients with oral squamous cell carcinoma, Australia publication-title: Eur. J. Cancer Part B Oral Oncol. doi: 10.1016/0964-1955(92)90007-N contributor: fullname: Dimitroulis – ident: ref_21 doi: 10.1371/journal.pone.0224067 – volume: 20 start-page: 165 year: 2018 ident: ref_26 article-title: Symptom Signatures and Diagnostic Timeliness in Cancer Patients: A Review of Current Evidence publication-title: Neoplasia doi: 10.1016/j.neo.2017.11.005 contributor: fullname: Koo – volume: 38 start-page: E2182 year: 2016 ident: ref_14 article-title: Early oral cancer diagnosis: The Aarhus statement perspective. A systematic review and meta-analysis publication-title: Head Neck doi: 10.1002/hed.24050 contributor: fullname: Seoane – volume: 140 start-page: 639 year: 2014 ident: ref_50 article-title: Public awareness of head and neck cancers: A cross-sectional survey publication-title: JAMA Otolaryngol. Head Neck Surg. doi: 10.1001/jamaoto.2014.867 contributor: fullname: Luryi – volume: 36 start-page: 405 year: 2007 ident: ref_37 article-title: Diagnostic delay of oral squamous cell carcinoma in two diagnosis centers in Córdoba Argentina publication-title: J. Oral Pathol. Med. doi: 10.1111/j.1600-0714.2007.00547.x contributor: fullname: Morelatto – volume: 16 start-page: e300 year: 2011 ident: ref_40 article-title: Early diagnosis in primary oral cancer: Is it possible? publication-title: Med. Oral Patol. Oral Cir. Bucal. contributor: fullname: Brakenhoff – volume: 112 start-page: S35 year: 2015 ident: ref_15 article-title: The relative length of the patient and the primary care interval in patients with 28 common and rarer cancers publication-title: Br. J. Cancer doi: 10.1038/bjc.2015.40 contributor: fullname: Lyratzopoulos – volume: 69 start-page: e112 year: 2019 ident: ref_23 article-title: Diagnosis and referral delays in primary care for oral squamous cell cancer: A systematic review publication-title: Br. J. Gen. Pract. doi: 10.3399/bjgp18X700205 contributor: fullname: Chen – volume: 51 start-page: 106 year: 2001 ident: ref_19 article-title: Detection of tongue cancer in primary care publication-title: Br. J. Gen. Pract. contributor: fullname: Kantola – volume: 37 start-page: 94 year: 2001 ident: ref_38 article-title: Influence of time delay and clinical upstaging in the prognosis of head and neck cancer publication-title: Oral Oncol. doi: 10.1016/S1368-8375(00)00066-X contributor: fullname: Kowalski – volume: 58 start-page: 898 year: 2020 ident: ref_49 article-title: Comparison of primary care doctors and dentists in the referral of oral cancer: A systematic review publication-title: Br. J. Oral Maxillofac. Surg. doi: 10.1016/j.bjoms.2020.06.009 contributor: fullname: Langton – volume: 51 start-page: 95 year: 2014 ident: ref_35 article-title: Delay in seeking specialized care for oral cancers: Experience from a tertiary cancer center publication-title: Indian J. Cancer doi: 10.4103/0019-509X.137934 contributor: fullname: Joshi – volume: 35 start-page: 77 year: 1997 ident: ref_43 article-title: Oral cancer: A retrospective study of 100 Danish cases publication-title: Br. J. Oral Maxillofac. Surg. doi: 10.1016/S0266-4356(97)90679-3 contributor: fullname: Pinholt – volume: 13 start-page: 353 year: 2012 ident: ref_55 article-title: Variation in number of general practitioner consultations before hospital referral for cancer: Findings from the 2010 National Cancer Patient Experience survey in England publication-title: Lancet Oncol. doi: 10.1016/S1470-2045(12)70041-4 contributor: fullname: Lyratzopoulos – volume: 7 start-page: 35 year: 2021 ident: ref_52 article-title: Conceptual Framework to Guide Early Diagnosis Programs for Symptomatic Cancer as Part of Global Cancer Control publication-title: JCO Glob. Oncol. doi: 10.1200/GO.20.00310 contributor: fullname: Koo – volume: 23 start-page: 237 year: 2011 ident: ref_5 article-title: Global oral health inequalities in incidence and outcomes for oral cancer: Causes and solutions publication-title: Adv. Dent. Res. doi: 10.1177/0022034511402082 contributor: fullname: Jonhson – volume: 112 start-page: S92 year: 2015 ident: ref_9 article-title: Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes? Systematic review publication-title: Br. J. Cancer doi: 10.1038/bjc.2015.48 contributor: fullname: Neal – volume: 39 start-page: 781 year: 2003 ident: ref_45 article-title: Factors associated with diagnostic delay of oral squamous cell carcinoma publication-title: Oral Oncol. doi: 10.1016/S1368-8375(03)00075-7 contributor: fullname: Onizawa – volume: 356 start-page: i6784 year: 2017 ident: ref_54 article-title: Referrals to dentists by GPs could delay diagnosis of oral cancer publication-title: BMJ doi: 10.1136/bmj.i6784 contributor: fullname: Yeung – volume: 92 start-page: 2885 year: 2001 ident: ref_18 article-title: The impact of patient and professional delay on survival in pharyngeal cancer publication-title: Cancer doi: 10.1002/1097-0142(20011201)92:11<2885::AID-CNCR10119>3.0.CO;2-G contributor: fullname: Koivunen – volume: 23 start-page: e23 year: 2018 ident: ref_4 article-title: Oral cancer: A multicenter study publication-title: Med. Oral Patol. Oral Cir. Bucal. contributor: fullname: Dhanuthai – volume: 108 start-page: 686 year: 2013 ident: ref_22 article-title: Measures of promptness of cancer diagnosis in primary care: Secondary analysis of national audit data on patients with 18 common and rarer cancers publication-title: Br. J. Cancer doi: 10.1038/bjc.2013.1 contributor: fullname: Lyratzopoulos – volume: 61 start-page: 29 year: 2016 ident: ref_36 article-title: Referral patterns for oral squamous cell carcinoma in Australia: 20 years progress publication-title: Aust. Dent. J. doi: 10.1111/adj.12314 contributor: fullname: Kaing – volume: 32 start-page: 1377 year: 2010 ident: ref_20 article-title: Proliferative activity and diagnostic delay in oral cancer publication-title: Head Neck doi: 10.1002/hed.21338 contributor: fullname: Seoane – volume: 147 start-page: 1040 year: 2020 ident: ref_2 article-title: Global trends in oral and pharyngeal cancer incidence and mortality publication-title: Int. J. Cancer doi: 10.1002/ijc.32871 contributor: fullname: Bosetti – volume: 25 start-page: 279 year: 2010 ident: ref_8 article-title: Oral and pharyngeal cancer control and early detection. Oral and pharyngeal cancer control and early detection publication-title: J. Cancer Educ. doi: 10.1007/s13187-010-0045-6 contributor: fullname: Silverman – volume: 46 start-page: 407 year: 2010 ident: ref_7 article-title: Living with oral cancer: Epidemiology with particular reference to prevalence and life-style changes that influence survival publication-title: Oral Oncol. doi: 10.1016/j.oraloncology.2010.02.015 contributor: fullname: Warnakulasuriya – volume: 27 start-page: 939 year: 2005 ident: ref_29 article-title: Oral and pharyngeal cancer: Analysis of patient delay at different tumor stages publication-title: Head Neck doi: 10.1002/hed.20270 contributor: fullname: Brouha – volume: 18 start-page: 45 year: 2013 ident: ref_41 article-title: The model of pathways to treatment: Conceptualization and integration with existing theory publication-title: Br. J. Health Psychol. doi: 10.1111/j.2044-8287.2012.02077.x contributor: fullname: Scott – volume: 139 start-page: 1346 year: 2008 ident: ref_30 article-title: Exploring the reasons for delay in treatment of oral cancer publication-title: J. Am. Dent. Assoc. doi: 10.14219/jada.archive.2008.0046 contributor: fullname: Peacock – volume: 7 start-page: 69 year: 2009 ident: ref_31 article-title: Delayed diagnosis of oral cancer in Iran: Challenge for prevention publication-title: Oral Health Prev. Dent. contributor: fullname: Sargeran |
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| Snippet | This investigation was aimed at determining the time intervals from the presenting symptoms until the beginning of oral cancer treatment and their relative... Simple SummaryInformation about the relative length of patient stays, primary care, and prereferral intervals (from symptom onset to specialist referral) is... |
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| SubjectTerms | Confidence intervals Diagnosis Generalized linear models Health services Hospitals Medical diagnosis Mortality Oral cancer Patients Primary care Questionnaires Statistical analysis Tumors Variables |
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| Title | Impact of the Presenting Symptom on Time Intervals and Diagnostic Routes of Patients with Symptomatic Oral Cancer |
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