Delays in treatment of oral cancer: a review of the current literature

Stefanuto, Peter; Doucet, Jean-Charles; Robertson, Chad

doi:10.1016/j.oooo.2013.12.407

Cited by 83 publications

(97 citation statements)

References 25 publications

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“…Screening is useful to detect OSCC at their early stage or to determine the status of potential malignant disorders; both are critical for reducing mortality in high-risk populations. The fourprotein panel could be used as a diagnostic adjunct to eliminate diagnosis delay due to patient delay by patients themselves or professional delay of diagnosis by the primary physician (23).…”

Section: Discussionmentioning

confidence: 99%

Saliva protein biomarkers to detect oral squamous cell carcinoma in a high-risk population in Taiwan

Chen

Chiang

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

101

133

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Most cases of oral squamous cell carcinoma (OSCC) develop from visible oral potentially malignant disorders (OPMDs). The latter exhibit heterogeneous subtypes with different transformation potentials, complicating the early detection of OSCC during routine visual oral cancer screenings. To develop clinically applicable biomarkers, we collected saliva samples from 96 healthy controls, 103 low-risk OPMDs, 130 high-risk OPMDs, and 131 OSCC subjects. These individuals were enrolled in Taiwan’s Oral Cancer Screening Program. We identified 302 protein biomarkers reported in the literature and/or through in-house studies and prioritized 49 proteins for quantification in the saliva samples using multiple reaction monitoring-MS. Twenty-eight proteins were successfully quantified with high confidence. The quantification data from non-OSCC subjects (healthy controls + low-risk OPMDs) and OSCC subjects in the training set were subjected to classification and regression tree analyses, through which we generated a four-protein panel consisting of MMP1, KNG1, ANXA2, and HSPA5. A risk-score scheme was established, and the panel showed high sensitivity (87.5%) and specificity (80.5%) in the test set to distinguish OSCC samples from non-OSCC samples. The risk score >0.4 detected 84% (42/50) of the stage I OSCCs and a significant portion (42%) of the high-risk OPMDs. Moreover, among 88 high-risk OPMD patients with available follow-up results, 18 developed OSCC within 5 y; of them, 77.8% (14/18) had risk scores >0.4. Our four-protein panel may therefore offer a clinically effective tool for detecting OSCC and monitoring high-risk OPMDs through a readily available biofluid.

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Section: Discussionmentioning

confidence: 99%

Saliva protein biomarkers to detect oral squamous cell carcinoma in a high-risk population in Taiwan

Chen

Chiang

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

101

133

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“…In a review on oral cancer and delayed diagnosis, the authors concluded that patient delay is the main factor contributing to the diagnostic delay in oral cancer [9]. However, in most developing countries where oral cancer is endemic, disruption of the health system seems to be a primary factor.…”

Section: Patient-related Factorsmentioning

confidence: 99%

“…Therefore, the most important and decisive factor is an early diagnosis. The tumor often passes unnoticed by the patient and healthcare professionals, a fact resulting in delayed treatment and compromising patient cure [9].…”

Section: Introductionmentioning

confidence: 99%

How to improve the early diagnosis of oral cancer?

Bandeira

Almeida

Carta

et al. 2017

BDS

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25 ResumoObjetivo: o carcinoma de células escamosas de cavidade bucal (CCECB) é uma das neoplasias malignas mais comuns, com cerca de 300 mil novos casos diagnosticados anualmente no mundo. Embora esteja na quinta posição entre os mais frequentes em homens no Brasil, o diagnóstico tardio continua a ser a principal causa de mau prognóstico. Revisamos a literatura para avaliar fatores que possam contribuir para o atraso de diagnóstico no câncer bucal considerando aspectos relacionados ao paciente, equipe de saúde e o Sistema de Saúde Pública. Material e Métodos: Foram pesquisados os bancos de dados Medline (PubMed), Scopus, Web of Science e Embase nos últimos 5 anos utilizando os seguintes descritores MeSH: carcinoma de células escamosas, neoplasias de boca e atraso diagnóstico. Os artigos deveriam conter em seus objetivos fatores que possam ter contribuído para o diagnóstico tardio do CCECB relacionado ao paciente, aos profissionais de saúde e ao Sistema de Saúde Pública em geral. Resultados: Cento e vinte artigos foram recuperados, sendo elegíveis, vinte e sete relacionados ao diagnóstico tardio de câncer bucal. Conclusão: a literatura mostrou que o atraso no diagnóstico e tratamento de pacientes com câncer bucal poderia ser minimizado, fornecendo informações sobre saúde, particularmente sobre fatores de risco a população, melhorando o treinamento e reciclagem de médicos e dentistas e melhorando o acesso ao sistema de saúde. As tecnologias de comunicação, dentre elas a telemedicina, pode desempenhar um papel fundamental no diagnóstico precoce de câncer bucal. ABsTRACTObjective: Oral squamous cell carcinoma (OSCC) is one of the most common malignant neoplasms, with 300,000 new cases annually diagnosed in the world. Although it appears in the fifth position among men in Brazil, late diagnosis continues to be a leading cause of poor prognosis. We reviewed the literature to evaluate factors that contribute to diagnostic delay in oral cancer considering aspects related to the patient, health team and public health system. Material and Methods: The Medline (PubMed), Scopus, Web of Science and Embase databases were searched in the last 5 years using the following MeSH descriptors: carcinoma, squamous cell; mouth neoplasms; delayed diagnosis. The articles should contain in their objectives factors contributing to the delayed diagnosis of OSCC related to the patient, healthcare professionals and public health system in general. Results: One hundred twenty articles were retrieved and 27 on the delayed diagnosis of oral cancer were eligible. Conclusion: The literature showed that the delay in the diagnosis and treatment of patients with oral cancer could be minimized by providing health information, particularly about risk factors, by improving the training and retraining of physicians and dentists and by improving access to the health system. The communication technologies such as telemedicine, can play a key role in the early diagnosis of oral cancer.

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“…The literature describes two relevant delays: "patient", and "professional" [2] (level of evidence 4). The patient delay is the interval between symptom onset and first medical consultation; professional delay begins when the patient first sees a physician (specialist or general practitioner); but this varies between publications, some putting the starting point when the patient is admitted to a specialized center and terminating with the initiation of treatment [2] (level of evidence 4).…”

Section: The Issue Of Delaysmentioning

confidence: 99%

“…The patient delay is the interval between symptom onset and first medical consultation; professional delay begins when the patient first sees a physician (specialist or general practitioner); but this varies between publications, some putting the starting point when the patient is admitted to a specialized center and terminating with the initiation of treatment [2] (level of evidence 4). Management delay may occur at all stages, especially before the first consultation, and is a major issue in head and neck oncology.…”

Section: The Issue Of Delaysmentioning

confidence: 99%

French Society of ENT (SFORL) guidelines for care pathway organization in head and neck oncology (short version). Early management of head and neck cancer

Cuny

Babin

Lacau-Saint-Guily

et al. 2015

European Annals of Otorhinolaryngology, Head and Neck Diseases

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Early management in oncology is based on coordination and high-quality exchange between the various health-care partners. The present guidelines are based on a literature search with levels of evidence. Treatment waiting time can be optimized by performing assessment as early as possible (Expert opinion), to limit the interval (ideally, less than 4 weeks) between first consultation and data collection. In the first specialist consultation, diagnostic work-up should be scheduled and the data required for management should be determined (Grade B). Work-up may be conducted on a day-care basis or with conventional admission (Expert opinion). The patient's medico-social context should be taken into account from the outset, with social work involvement whenever necessary (Expert opinion). Pain and nutritional management should be planned for (Grade A) and realistic therapeutic education be provided (Expert opinion). Community-hospital teamwork for supportive care should be optimized (Expert opinion). Management should be early and multidisciplinary, to shorten delay between diagnosis and treatment initiation.

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Delays in treatment of oral cancer: a review of the current literature

Cited by 83 publications

References 25 publications

Saliva protein biomarkers to detect oral squamous cell carcinoma in a high-risk population in Taiwan

Saliva protein biomarkers to detect oral squamous cell carcinoma in a high-risk population in Taiwan

How to improve the early diagnosis of oral cancer?

French Society of ENT (SFORL) guidelines for care pathway organization in head and neck oncology (short version). Early management of head and neck cancer

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