Reasons for Delayed Presentation in Patients with Oral Cancer to the Teaching Hospital Karapitiya

Abstract

Background: Oral cancer is one of the leading malignancies among males in Sri Lanka and the most common cause of death. Early detection/diagnosis, treatment and management are vital to reduce morbidity and mortality among patients with oral cancer and improve the Quality of Life (QoL). Objectives: To identify the reasons for delayed presentation of oral cancer to the oral and maxillofacial clinic (OMC), Teaching Hospital Karapitiya (THK), Sri Lanka, and possible patient-associated factors for the delayed presentation. Methods: A hospital-based descriptive cross-sectional study was conducted incorporating 106 patients with oral cancer. A self-designed, pre-tested, interviewer-administered questionnaire was used to collect socio-demographic and clinical variables. The delayed presentation has been considered if the patient had taken more than three months to visit a healthcare practitioner. Data were analysed using SPSS version 20.0. Chi-square test was used to find out associations of the selected socio-demographic and clinical variables. At the time of diagnosis, stages I and II were considered as ‘early stage’ and stages III and IV were considered as ‘advanced stage’. Results: The mean (SD) age of the sample was 55.03 (±12.84) years. Majority of the patients (69%) met the healthcare practitioner within three months; the mean (SD) time duration for the first visit was 4.6 (±2.35) weeks. Among patients who delayed presentation (31% of the sample), 61% of patients were diagnosed with advanced stage of oral cancer. The delayed presentation was significantly influenced by level of education (p=0.027). However, no significant association was found with respect to age, gender, monthly income, and health related habits like betel chewing, drinking alcohol, and smoking. Conclusions: The delayed presentation of oral cancer is significantly associated with level of education. The advanced stage of oral cancers had increased due to the delay of presentation. An awareness session on cancer-specific knowledge for oral cancer patients is recommended to minimize the delayed presentation. This would be more important to increase the QoL of patients with oral cancer and reduce the cancer care burden of the country.