Factors Influencing the Delay in Head and Neck Cancer Diagnosis in Lebanon.

Abstract

To evaluate factors affecting the delay in head and neck cancer (HNC) diagnosis in Lebanon. Patients with HNC presenting between August 1, 2023, and August 1, 2024, to the American University of Beirut Medical Center (AUBMC) were recruited. A questionnaire was administered to characterize the demographic, socioeconomic, and clinical factors affecting their cancer diagnosis, and their charts were reviewed retrospectively for their cancer demographics and to account for any discrepancies. A total of 78 participants were analyzed: 34 with early-stage (Stages 1 and 2) and 44 with late-stage (Stages 3 and 4) HNC. Late-stage participants had a significantly lower rate of university education (43.2% vs. 70.6%; p = 0.016), private insurance (27.3% vs. 64.7%; p = 0.001), and regular dental check-ups (29.5% vs. 52.9%; p = 0.036). They also reported more financial issues (52.3% vs. 26.5%; p = 0.022) and lack of awareness (65.9% vs. 29.4%; p = 0.001). Late-stage patients traveled longer distances for care (p = 0.043) and had issues with transport (38.6% vs. 8.8%; p = 0.003). Presentation (Type 1 delay) and referral (Type 2 delay) delays were significantly longer for late-stage HNC patients (median: 45 vs. 14 days, p < 0.001; 14 vs. 8.5 days, p < 0.001, respectively). Diagnosis delays were similar between groups (median: 7.00 days), but with a statistically significant mean difference (6.21 vs. 7.74 days). This study highlights the need to address patient awareness and healthcare barriers to improve timely HNC diagnosis. Enhancing symptom awareness and referral efficiency can significantly reduce diagnostic delays and associated morbidity in Lebanon.