Assessing delays in laryngeal cancer treatment
Smith MM, Abrol A, and Gardner GM. Assessing delays in laryngeal cancer treatment Laryngoscope 2016 Jul;126(7):1612-5.
OBJECTIVES/HYPOTHESIS: To see if there has been a decrease in patient delay, professional delay, diagnostic delay, and treatment delay in laryngeal cancer.
STUDY DESIGN: Institutional review board-approved retrospective chart review of patients diagnosed with laryngeal cancer.
METHODS: Nine hundred sixty-six patients with International Classification of Diseases, Ninth Revision code for laryngeal cancer were identified from 1993 to 2013. Two hundred fifty patients met inclusion criteria. Patients were placed into two groups based on time at presentation to primary care physician, 1993 to 2004 and 2005 to 2013. Patient delay, professional delay, diagnostic delay, and treatment delay were calculated. Statistical analysis was applied using the Student t test and generalized linear model.
RESULTS: From 1993 to 2004, patient delay was 88.7 days, professional delay was 40.9 days, diagnosis delay was 33.1 days, and treatment delay was 24.7 days. From 2005 to 2013, patient delay was 119.2 days, professional delay was 37.9 days, diagnosis delay was 23.8 days, and treatment delay was 23.2 days. Comparison using the Student t test demonstrated the difference in patient delay (shorter before 2005) was statistically significant (P = .045), whereas professional delay (P = .269), diagnosis delay (P = .289), and treatment delay (P = .328) did not reveal any significant differences. There was no association between stage at initial diagnosis and days prior to ear, nose, and throat visit (P = .402).
CONCLUSIONS: Delays in the presentation of patients to primary care physicians and otolaryngologists have significantly increased in the past 9 years. Earlier referral to otolaryngologists from primary care physicians in high-risk patients with voice changes will lead to more prompt diagnosis and treatment of laryngeal cancer.
LEVEL OF EVIDENCE: 4. Laryngoscope, 126:1612-1615, 2016.
Medical Subject Headings
Aged; Delayed Diagnosis; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged; Retrospective Studies; Time-to-Treatment