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

Abstract

To assess the impact of treatment delay on survival of oral/oropharyngeal cancer (OSCC). We followed 5743 OSCCs between 2004 and 2009 from a population-based screening program and ascertained death until the end of 2012. 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. Treatment delay longer than 6 weeks for OSCCs detected via a population-based screening program had unfavorable survival.