Long Delays Are Not Unusual Before Oral Cancer Treatment

Many signs of oral cancer are obvious and painful. Yet it takes more than 6 months for most people to go to the doctor, get diagnosed, and begin treatment.

That's one finding of a new study from the University of California, San Francisco.

Such a delay can be deadly. More than 4 out of 5 people with early-stage oral cancer will survive at least 5 years after diagnosis. But among those with late-stage cancer, only about 1 in 5 live at least that long.

In the study, researchers looked at how long it took people with oral cancer to get diagnosed and start treatment. Fifty people were part of the study. All were diagnosed with oral squamous cell carcinoma between 2003 and 2007.

The researchers looked at six time delays:

1. Time between first noticing symptoms and visiting the doctor (average delay: 105 days)
2. Time between visiting the doctor and getting a biopsy or referral to a specialist (36 days)
3. Time between biopsy/referral to actually visiting a specialist (17 days)
4. Time between visiting a specialist and having tests done (10 days)
5. Time between having tests done and starting to consider treatment options (21 days)
6. Time between considering treatment options and starting treatment (17 days)

The total average delay – from noticing symptoms to starting treatment – was 206 days. That's nearly 7 months. Total delays for people in the study ranged from just under 2 months to more than 26 months.

Some studies have shown that patients with health insurance are more likely to visit the dental office. Other studies have shown that people with no insurance or Medicaid are less likely to visit a dental office. This may be the major reason why people without insurance are more likely to be diagnosed with oral cancer at later stages.

Dentists also can look for signs of oral cancer during a check-up. However, many people at high risk for oral cancer do not make regular dental visits.

Almost all of the delays in this study originated with patients, not doctors or other health professionals.

Oral cancer is diagnosed in 30,000 people each year in the United States. About 8,500 people die from the disease. Symptoms include:

• Lumps, swellings or rough spots
• Velvety white, red or speckled patches
• Unexplained bleeding
• Sores that bleed easily and do not heal within about two weeks
• Problems with chewing, swallowing, speaking or moving your jaw or tongue
• A sore throat that does not go away

The study appears in the October issue of the Journal of the American Dental Association.