This is a review from Canada where they attempt to relate the delays in oral cancer presentation to treatment and the impact on stage, diagnosis and survival. They recognise that potentially the most significant delay is between the patient first noticing the symptom and the first consultation with a healthcare professional. They cite various papers to support this, including two from the UK where 29-39% of patients waited longer than three months. They quote the UK guidelines and the Canadian equivalent of six weeks from date of specialist consultation to definitive treatment. They acknowledge that there is little evidence to base any recommendation and it is largely expert opinion. They further cite that those at an advanced stage at diagnosis, the primary treatment with radiotherapy, treatment in an academic centre, and transitions in care are associated with an increased treatment delay. The current understanding of a four-six week wait between definitive diagnosis and treatment seems to be acceptable.

Delays in oral cancer care.
Gigliotti J, Madathil S, Makhoul N.
INTERNATIONAL JOURNAL OF ORAL & MAXILLOFACIAL SURGERY
2019;48:1131-7.
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Stuart Clark

Manchester Royal Infirmary, Manchester, UK.

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