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Background: Treatment of locally-advanced squamous cell carcinoma of the head and neck (SCCHN) requires multi-disciplinary care often resulting in a prolonged diagnosis to treatment interval (DTI). This study aims to identify factors that influence DTI and to assess the impact of DTI on treatment outcomes. Methods:The medical records of 135 patients with SCCHN who were treated with definitive chemoradiotherapy between 2000 and 2009 at the Clement J Zablocki VA Medical Center were reviewed and analyzed.Results: Median DTI was 44 days. A Cox-Model identified that transfer patients had prolonged DTI. Longer DTI had a significant negative impact on overall survival (RR 1.009, p = 0.0386) but did not impact distant (RR 0.99, p = 0.89) or local control (0.99, p = 0.23). Conclusion:Increased DTI in patients with SCCHN results in a statistically significant negative survival impact. Efforts need to be directed to improving DTI and on expediting and streamlining the care of transfer patients.

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