Oral cancer: Delays in referral and diagnosis persist

A qualitative study examining the experience of primary care dentists in the detection and management of potentially malignant lesions. 1. Factors influencing detection and the decision to refer

“…The complexity of the judgement task often produces greater individual variation 30 and one of the great diffi culties with PMLs is the number of clinical presentations that the disease can take. 8,28 This has already been reported in the context of PMLs 5,7 and has been confi rmed by the present study.…”

“…Code 1: proactive in screening A dentist's attitude to screening is considered to be one of the important factors in detecting the early stages of malignancy 7,19,21 and while some PCDs in this study were proactive, there was a lot of recorded variation.…”

“…A set of opening questions was developed for the semi-structured interviews from existing research on delays in oral cancer presentation 7,[15][16][17][18][19][20][21] and the results of an earlier pilot study by the same authors. 22 In accordance with Carter and Henderson, 23 these were open-ended questions and investigated the following areas: experience of soft tissue lesion referrals; factors used in formulating the decision to refer; attitudes to secondary care; and attitudes to other health professionals.…”

The two-week wait cancer initiative on oral cancer; the predictive value of urgent referrals to an oral medicine unit

“…9 Substantial delays experienced by oral cancer patients are discussed by previous authors. 10 Among 120 oral cancers diagnosed in a hospital setting, only 75% had an indication of a suspected malignancy. 10 White et al 11 speculated that a high proportion of dental practitioners were unaware of the mechanisms in place for urgent oral medicine referrals.…”

“…10 Among 120 oral cancers diagnosed in a hospital setting, only 75% had an indication of a suspected malignancy. 10 White et al 11 speculated that a high proportion of dental practitioners were unaware of the mechanisms in place for urgent oral medicine referrals. The fi nding that only four of the letters suspecting a malignancy or giving features of a malignancy were received on a two-week wait cancer pro-forma suggest that improvements in communication on cancer referral guidelines by primary care trusts with local medical and dental practitioners is needed.…”