Patient and health care delays in large (class T3–T4) oral, oropharyngeal, and laryngeal carcinomas

Markus Atula, Katri Aro, Heikki Irjala, Elina Halme, Anna Jouppila-Mättö, Petri Koivunen, Tommy Wilkman, Henry Blomster, Antti Mäkitie, Timo Atula

Research output: Contribution to journalArticleScientificpeer-review

2 Citations (Scopus)


Background: Head and neck cancers (HNCs) are often diagnosed at an advanced stage. We investigated the lengths and factors associated with patient, primary health care (PHC), and specialist care (SC) delays in T3–T4 oral, oropharyngeal, and laryngeal cancer. Methods: A nationwide prospective questionnaire-based study (n = 203) with the 3-year long data collection period. Results: The median patient, PHC and SC delays were 58, 13, and 43 days, respectively. Lower level of education, heavy alcohol use, hoarseness, difficulties breathing, and eventual palliative treatment associated with a longer patient delay. A lump on the neck or facial swelling associated with a shorter PHC delay. Conversely, if symptoms were treated as an infection, PHC delay was longer. The treatment modality and tumor site affected SC delay. Conclusions: Patient delay stands as the most notable factor contributing to delays before treatment. HNC symptom awareness thus remains especially important among HNC risk groups.

Original languageEnglish
Pages (from-to)1215-1225
Number of pages11
JournalHead and Neck
Issue number5
Publication statusPublished - 2023
Publication typeA1 Journal article-refereed


  • cancer
  • head and neck
  • health care delay
  • patient delay
  • treatment delay

Publication forum classification

  • Publication forum level 3

ASJC Scopus subject areas

  • Otorhinolaryngology


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