THE TIME-INTERVAL BETWEEN ONSET OF SYMPTO MS AND INTRODUCTION OF THERAPY IN PATIENTS WITH HEAD AND NECK-CANCER

The interval between the onset of symptoms in patients with head and n eck cancers and the introduction of treatment was evaluated. During a 1-year period, patients were interviewed to determine the duration of any delays from the onset of complaints until the first visit to a doc tor. Also asked was how long it took to be referred to an ENT speciali st and actual referral to our department. We then determined the inter val from diagnosis to the introduction of therapy. It was found that t he delay of patients who went directly to an otorhinolaryngologist was shorter (median, 8 weeks) than that of patients who first went to the ir family doctors (median, 13 weeks) (P<0.02). The latter then took an additional 4 weeks before sending patients to an otorhinolaryngologis t. Referral from the ENT specialist to our department took another 2 w eeks, as well as our staging and pre-therapeutic management. Our findi ngs show that the patient himself is the critical factor in delaying d iagnosis and therapy. Tumor patients with greater professional qualifi cation went to their doctors earlier (P<0.0001) or more often went dir ectly to an ENT specialist (P<0.002). Consultations of physicians with out experience in otorhinolaryngology caused yet further delays.