Delay in referral of oropharyngeal squamous cell carcinoma to secondary care correlates with a more advanced stage at presentation, and is associated with poorer survival.

Abstract:

:Squamous carcinoma of the oropharynx presents with symptoms common to many benign diseases, and this can cause delay in referral to secondary care. We investigate delay in referral, defining this as the time from symptom-onset to date of general practitioners referral letter to secondary care, and the effect of that delay, using a retrospective case notes based study of patients presenting at our institution with oropharyngeal squamous carcinoma between 1995 and 2005. Using correlation analysis and ordinal regression, we examined the relationship between increased referral delay from primary care, clinical stage at presentation, and survival. Increasing time from symptom onset to referral to secondary care was positively correlated with more advanced disease stage at presentation (r(s) = +0.346, P = 0.004). This was confirmed with ordinal regression modelling (delay estimate = 0.045, P = 0.042). Patients with delay of less than 6 weeks had significantly improved survival compared to those with a delay of greater than 6 weeks (P = 0.032). For every 1 week of delay in referral, we estimate that the stage of presentation will progress by 0.045 of 'a stage'.

journal_name

Br J Cancer

authors

Pitchers M,Martin C

doi

10.1038/sj.bjc.6603044

subject

Has Abstract

pub_date

2006-04-10 00:00:00

pages

955-8

issue

7

eissn

0007-0920

issn

1532-1827

pii

6603044

journal_volume

94

pub_type

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