Study reveals patient-related delays in head and neck cancer diagnosis

A recent study by the University of Helsinki has shed light on the delays in diagnosing head and neck cancers, a range of cancers that are typically identified in advanced stages. Contrary to common assumptions, the study found that primary healthcare providers effectively recognize these cancers, but the biggest delay in starting treatment often originates from the patients themselves.

Head and neck cancers, encompassing a broad spectrum of cancer types with various symptoms, are diagnosed annually in about 900 cases in Finland. Their rarity and diverse symptoms make it challenging for both patients and doctors to recognize them early. These cancers are usually diagnosed at advanced stages, requiring expensive combination treatments and leading to poorer quality of life and prognosis.

Dr. Markus Atula, in his doctoral research on head and neck cancers, investigated the reasons behind the delays between the onset of initial symptoms and the commencement of treatment. It was revealed that delays caused by the patients themselves were the primary factor slowing down treatment initiation. In contrast, primary healthcare services identified these cancers quickly, despite their rarity in general practice.

Key findings of the study include:

  • Patient Delay: The delay caused by patients hesitating to seek medical help was the biggest factor contributing to treatment delays. Patients typically contacted healthcare services within a month of noticing initial symptoms.

  • Varied Symptoms: Symptoms like a lump in the neck prompted quicker medical consultation, whereas hoarseness and breathing difficulties led to slower response. Factors like retirement, unemployment, lower education levels, and heavy alcohol use were linked to longer patient delays.

  • Primary Healthcare Efficiency: Despite the rarity of these cancers in primary healthcare (1:6000 patients), the median delay caused by general practitioners was only five days. The overall median delay in primary healthcare was 2-3 weeks, indicating effective identification of these cancers at this level.

  • Challenges in Specialized Care: The median delay in specialized care was relatively longer (1-2 months). While shortening this delay is more challenging, it is essential for better outcomes, as seen in countries like Denmark and Norway with shorter specialized care delays.

To further reduce these delays, Atula suggests increasing awareness of symptoms among the general population and targeted education for high-risk groups. Improving the ability of primary healthcare to identify and promptly respond to urgent cases is also crucial.

This study emphasizes the importance of reducing delays in diagnosing head and neck cancers, as early detection significantly impacts treatment outcomes, costs, and patients’ quality of life. Despite large tumors causing noticeable symptoms, only 40% of patients suspected cancer as the underlying cause. Therefore, increasing awareness and enhancing primary healthcare responsiveness are key steps towards better management of these cancers.

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