Factors associated with diagnostic delay among patients with oral squamous cell carcinoma: a hospital-based observational study.
TL;DR
Educational status, diabetic status and primary lesion site stage were significantly associated with diagnostic delay, and Multivariable regression identified educational status as an independent factor associated with total diagnostic delay.
Abstract
Background
Delayed diagnosis of oral squamous cell carcinoma (OSCC) is associated with advanced-stage disease, more extensive treatment, and poorer survival. This study evaluated factors associated with diagnostic delay among patients with OSCC.
Methods
A cross-sectional study was conducted among 100 patients with histopathologically confirmed OSCC attending a tertiary cancer centre. Demographic, behavioral, medical, clinical, and healthcare-related data were obtained through structured interviews and review of medical records. Total diagnostic delay was defined as the interval between symptom onset and histopathological diagnosis. Associations with diagnostic delay were analyzed using non-parametric tests, and independent predictors were identified using multivariable linear regression.
Results
The median total diagnostic delay was 176.5 days (interquartile range: 107.0-279.5 days), with a mean delay of 190.2 ± 113.6 days. Educational status, diabetic status and primary lesion site stage were significantly associated with diagnostic delay (p < 0.05). Multivariable regression identified educational status as an independent factor associated with total diagnostic delay. Appointment delays, fear of diagnosis, financial constraints, lack of awareness, and symptom neglect were the most frequently reported reasons for delayed diagnosis.
Conclusions
Diagnostic delay in OSCC remains substantial and is influenced primarily by educational, clinical, and healthcare-related factors. Improving oral health literacy, public awareness, and referral pathways may facilitate earlier diagnosis and improve patient outcomes.