Impact of treatment delay on survival of oral/oropharyngeal cancers: Results of a nationwide screening program

William Wang-Yu Su; Yi-Huah Lee; Amy Ming-Fang Yen; Sam Li-Sheng Chen; Chen-Yang Hsu; Sherry Yueh-Hsia Chiu; Jean Ching-Yuan Fann; Yi-Chia Lee; Han-Mo Chiu; Shu-Chun Hsiao; Tsui-Hsia Hsu; Hsiu-Hsi Chen

doi:10.1002/hed.26504

Impact of treatment delay on survival of oral/oropharyngeal cancers: Results of a nationwide screening program

Head Neck. 2021 Feb;43(2):473-484. doi: 10.1002/hed.26504. Epub 2020 Oct 13.

Authors

William Wang-Yu Su^{1

2}, Yi-Huah Lee³, Amy Ming-Fang Yen⁴, Sam Li-Sheng Chen⁴, Chen-Yang Hsu³, Sherry Yueh-Hsia Chiu^{5

6}, Jean Ching-Yuan Fann⁷, Yi-Chia Lee^{8

9}, Han-Mo Chiu⁸, Shu-Chun Hsiao¹⁰, Tsui-Hsia Hsu¹⁰, Hsiu-Hsi Chen³

Affiliations

¹ Division of Otorhinolaryngology-Head & Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
² School of Medicine, Tzu Chi University, Hualien, Taiwan.
³ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁴ School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
⁵ Department of Health Care Management and Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan.
⁶ Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁷ Department of Health Industry Management, College of Healthcare Management, Kainan University, Tao-Yuan, Taiwan.
⁸ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁹ Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei, Taiwan.
¹⁰ Health Promotion Administration, Ministry of Health and Welfare, Cancer Prevention and Control Division, Taiwan.

Abstract

Background: To assess the impact of treatment delay on survival of oral/oropharyngeal cancer (OSCC).

Methods: We followed 5743 OSCCs between 2004 and 2009 from a population-based screening program and ascertained death until the end of 2012.

Results: The hazard ratios (HRs) of mortality from OSCC were 1.46 (1.30-1.65) and 1.18 (1.04-1.33) in univariable and multivariable analyses, respectively, for treatment delay longer than 6 weeks compared with that shorter than 3 weeks. The corresponding figures were 1.12 (1.01-1.24) and 1.00 (0.91-1.11) for treatment delay between 3 and 6 weeks. Advancing age (1.01), higher stage (stage II: 1.84, stage III: 2.97, stage IV: 6.33), cancer in tongue (1.37), or hard palate (1.63) had higher HR of mortality (P < .05). However, treatment at medical center had a lower mortality (0.83, 0.75-0.91) than local/regional hospital.

Conclusions: Treatment delay longer than 6 weeks for OSCCs detected via a population-based screening program had unfavorable survival.

Keywords: betel quid chewing; cigarette smoking; oral/oropharyngeal cancer; survival; treatment delay.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Areca
Early Detection of Cancer
Humans
Mouth Neoplasms* / diagnosis
Mouth Neoplasms* / therapy
Oropharyngeal Neoplasms*
Risk Factors
Time-to-Treatment