PMID- 12692876
OWN - NLM
STAT- MEDLINE
DCOM- 20030807
LR  - 20061005
IS  - 1043-3074 (Print)
IS  - 1043-3074 (Linking)
VI  - 25
IP  - 5
DP  - 2003 May
TI  - Diagnostic delays in laryngeal carcinoma: professional diagnostic delay is a 
      strong independent predictor of survival.
PG  - 389-94
AB  - BACKGROUND: Clinical stage at the time of diagnosis is the most important 
      determinant of prognosis in cancers of the head and neck. Accordingly, delay in 
      diagnosis could worsen survival in laryngeal cancer, although this hypothesis has 
      not been verified in previous studies. METHODS: To determine the effects of 
      patient and professional diagnostic delays on survival in patients with laryngeal 
      squamous cell carcinoma (LSCC), a population-based sample of 66 patients with 
      LSCC in Northern Finland between 1990 and 1995 was investigated. In addition to 
      clinical data from tertiary care units and mortality data from the national death 
      register, we collected data about the first medical visit in primary care that 
      resulted, subsequently, in the diagnosis of malignancy. RESULTS: Long 
      professional delay in diagnosis (>or=12 months) was an independent and 
      statistically significant determinant of worsened prognosis (adjusted relative 
      hazard of death 4.74, p =.05). There was no correlation between patient delay and 
      prognosis. Another significant factor related to impaired prognosis was advanced 
      stage (IV vs I-III, adjusted relative hazard of death 5.18, p =.02). Long 
      professional delay was not significantly related to any of the demographic or 
      clinical characteristics. CONCLUSIONS: A long professional delay is a marked and 
      independent determinant of impaired survival in laryngeal carcinoma and equals 
      the effect of advanced stage. However, unlike in most other cancers, early 
      symptoms and slow tumor growth give the physician a fairly long time to reach the 
      correct diagnosis before the delay turns out to be fatal.
CI  - Copyright 2003 Wiley Periodicals, Inc.
FAU - Teppo, Heikki
AU  - Teppo H
AD  - Department of Otorhinolaryngology, University of Oulu, BOX 5000, FIN-90014, 
      Finland. heikki.teppo@oulu.fi
FAU - Koivunen, Petri
AU  - Koivunen P
FAU - Hyrynkangas, Kalevi
AU  - Hyrynkangas K
FAU - Alho, Olli-Pekka
AU  - Alho OP
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Head Neck
JT  - Head & neck
JID - 8902541
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Squamous Cell/*diagnosis/mortality/pathology
MH  - Female
MH  - Humans
MH  - Laryngeal Neoplasms/*diagnosis/mortality/pathology
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Risk Factors
MH  - Survival Rate
MH  - Time Factors
EDAT- 2003/04/15 05:00
MHDA- 2003/08/09 05:00
CRDT- 2003/04/15 05:00
PHST- 2003/04/15 05:00 [pubmed]
PHST- 2003/08/09 05:00 [medline]
PHST- 2003/04/15 05:00 [entrez]
AID - 10.1002/hed.10208 [doi]
PST - ppublish
SO  - Head Neck. 2003 May;25(5):389-94. doi: 10.1002/hed.10208.