Referral delay in diagnosis of oro/oropharyngeal cancer in Israel

The delay, stage at diagnosis and referral pattern of 543 oro/oropharyngeal cancer patients in Israel were investigated. About two-thirds of the malignancies were diagnosed at early stages. In more than two-thirds there was a delay of at least 2 months from the onset of signs and symptoms up to diagnosis, with a non-significant relationship between stage and delay. A significant correlation (P= 0.002) was found between delay and malignancy site. A delay of more than 4 months was observed in 71% of the patients with lip cancer. Cancers of the lip, palate and buccal mucosa were more frequently diagnosed at early stages. A significant correlation (P= 0.001) was found between stage at diagnosis and referral source. Although 86% of the cancers were diagnosed by physicians, nearly half were already at an advanced stage; when the cancers were diagnosed by dentists, 81% of the remainder were at early stages. No significant relationship was found between the referral medical profession and site of diagnosis. No nasopharyngeal, oropharyngeal or laryngeal cancers were diagnosed by dentists.