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Annals of Medicine and Medical Sciences
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  3. Determining Professional Delay Experienced by Patients with Cancer of …
Original Article Open Access

Determining Professional Delay Experienced by Patients with Cancer of the Upper Aerodigestive Tract at a Tertiary Hospital in South Africa

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Annals of Medicine and Medical SciencesVol. 05, (2026) May 12, 2026pp. 665 - 670
116 120
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Abstract
Introduction: Cancer of the upper aerodigestive tract (UADT) represents a significant health burden globally, particularly in South Africa. Profession delay, the interval from symptom recognition to consultation with a healthcare professional, significantly impacts patient outcomes. This study aims to determine the profession delay experienced by patients with UADT cancer at a tertiary hospital in South Africa. Methods: This was a prospective, quantitative study conducted among patients who received care at Dr George Mukhari Academic Hospital (DGRAH) from 1 December 2019 to 31 June 2020. The professional delay was calculated from the first consultation with a health care professional to histological confirmation. In addition, Professional delay was divided into secondary delay (the time from the first consultation to referral to DGMAH) and tertiary delay (the period from presentation to DGMAH to the date of biopsy results). Results: A total of 106 patients took part in the study. The median professional delay was found to be 2.5 months. Most patients (83%) presented in advanced stages of cancer. The average secondary delay was 2 months whereas the average tertiary delay was 0.3 months and the differences were statistically significant (p<0.05). The average professional delay was significantly higher among chronic patients than those who were not chronic (p<0.05). It was also found that cancer stages were significantly associated with profession delays (p<0.05). Conclusion: Patients with UADT cancer at the tertiary hospital experienced a notable profession delay, highlighting potential areas for improvement in healthcare delivery and patient education. Efforts to reduce profession delay are crucial for timely diagnosis and improved outcomes in UADT cancer patients. Further research is warranted to explore factors contributing to profession delay and interventions to mitigate its impact.
References
  1. [1] Lo Nigro C, Denaro N, Merlotti A, Merlano M. Head and neck cancer: Improving outcomes with a multidisciplinary approach. Cancer Manag Res. 2017;9:363-371. doi:10.2147/CMAR.S115761
  2. [2] Adeola H, Afrogheh A, Hille J. The burden of head and neck cancer in Africa: the status quo and research prospects. South African Dent J. 2018;73(8). doi:10.17159/2519-0105/2018/v73no8a1
  3. [3] Alho O-P, Teppo H, Mäntyselkä P, Kantola S. Head and neck cancer in primary care: presenting symptoms and the effect of delayed diagnosis of cancer cases. CMAJ. 2006;174(6):779-784. doi:10.1503/cmaj.050623
  4. [4] Mwansasu C, Liyombo E, Moshi N, Mpondo BCT. Pattern of head and neck cancers among patients attending muhimbili national hospital tanzania. Tanzan J Health Res. 2015;17(1):1-6. doi:10.4314/thrb.v17i1.4
  5. [5] Gathere S, Mutuma G, Korir A, Musibi A. Head and Neck Cancers four year trend at the Nairobi Cancer Registry. Afr J Heal Sci. 2011;19:30-35. http://www.ajhsjournal.or.ke/admin/current/GXU0dG1Bk9u.pdf
  6. [6] Jethwa AR, Khariwala SS. Tobacco-related carcinogenesis in head and neck cancer. Cancer Metastasis Rev. 2017;36(3):411-423. doi:10.1007/s10555-017-9689-6
  7. [7] Dal Maso L, Torelli N, Biancotto E, et al. Combined effect of tobacco smoking and alcohol drinking in the risk of head and neck cancers: a re-analysis of case–control studies using bi-dimensional spline models. Eur J Epidemiol. 2016;31(4):385-393. doi:10.1007/s10654-015-0028-3
  8. [8] Freedman ND, Schatzkin A, Leitzmann MF, Hollenbeck AR, Abnet CC. Alcohol and head and neck cancer risk in a prospective study. Br J Cancer. 2007;96(9):1469-1474. doi:10.1038/sj.bjc.6603713
  9. [9] Montero PH, Patel SG, Ganly I. Aetiology of Head and Neck cancer. In: Watkinson JC, Clarke RW, eds. Scott-Brown’s Otorhinolaryngology and Head and Neck Surgery: Volume 3: Head and Neck Surgery, Plastic Surgery. 8th editio. CRC Press; 2018:10.
  10. [10] McGurk M, Chan C, Jones J, O’Regan E, Sherriff M. Delay in diagnosis and its effect on outcome in head and neck cancer. Br J Oral Maxillofac Surg. 2005;43(4):281-284. doi:10.1016/j.bjoms.2004.01.016
  11. [11] Stefanuto P, Doucet JC, Robertson C. Delays in treatment of oral cancer: A review of the current literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117(4):424-429. doi:10.1016/j.oooo.2013.12.407
  12. [12] Argiris A, Karamouzis M., Raben D, Ferris RL, Tavassoli M, Mahmut Ozsahin E. Head and neck cancer. Lancet. 2008;371(9625):1695-1705. Doi: https://doi.org/10.1016/S0140-6736(08)60728-X
  13. [13] Howren MB, Christensen AJ, Karnell LH, Funk GF. Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine. J Consult Clin Psychol. 2013;81(2):299-317. doi:10.1037/a0029940
  14. [14] Popescu B, Paun O, Balalau C. Psychological profile of laryngectomized patients Psychological profile of laryngectomized patients. J Mind Med Sci. 2016;3(1):31-38.
  15. [15] Allison P, Franco E, Feine J. Predictors of professional diagnostic delays for upper aerodigestive tract carcinoma. Oral Oncol. 1998;34(2):127-132. doi:10.1016/S1368-8375(97)00078-X
  16. [16] Allison P, Franco E, Black M, Feine J. The role of professional diagnostic delays in the prognosis of upper aerodigestive tract carcinoma. Oral Oncol. 1998;34(2):147-153. doi:10.1016/S1368-8375(97)00088-2
  17. [17] Koivunen P, Rantala N, Hyrynkangas K, Jokinen K, Alho OP. The impact of patient and professional diagnostic delays on survival in pharyngeal cancer. Cancer. 2001;92(11):2885-2891. doi:10.1002/1097-0142(20011201)92:11.
  18. [18] McCarthy CE, Field JK, Rajlawat BP, Field AE, Marcus MW. Trends and regional variation in the incidence of head and neck cancers in England: 2002 to 2011. Int J Oncol. 2015;47(1):204-210. doi:10.3892/ijo.2015.2990
  19. [19] Grégoire V, Lefebvre JL, Licitra L, Felip E. Squamous cell carcinoma of the head and neck: EHNS-ESMO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21(SUPPL. 5):184-186. doi:10.1093/annonc/mdq185
  20. [20] Onyango J., Macharia I. Delays in diagnosis, referral and management of head and neck cancer presenting at Kenyatta National Hospital. East Afri Med J. 2006;83(4):85-91.
  21. [21] Kassirian S, Dzioba A, Hamel S, et al. Delay in diagnosis of patients with head-and-neck cancer in Canada: Impact of patient and provider delay. Curr Oncol. 2020;27(5):e467-e477. doi:10.3747/co.27.6547
  22. [22] Nieminen M, Aro K, Jouhi L, Bäck L, Mäkitie A, Atula T. Causes for delay before specialist consultation in head and neck cancer. Acta Oncol (Madr). 2018;57(12):1677-1686. doi:10.1080/0284186X.2018.1497297
  23. [23] Reid BC, Warren JL, Rozier G. Comorbidity and early diagnosis of head and neck cancer in a Medicare population. Am J Prev Med. 2004;27(5):373-378. doi:10.1016/j.amepre.2004.07.018