Delay in presentation of oral cancer: A multifactor analytical study

Background. Patients with oral cancer often present late to the doctor maki ng treatment difficult, expensive and sometimes unsuccessful, Delay in pres entation may be considered to be a health risk-taking behaviour. The presen t study analyses the psychosocial factors related to delay in presentation of oral cancer patients through the Triandis' model of health-seeking behav iour and also examines the relationship between delay and the stage of canc er. Methods, Seventy-nine oral cancer patients were interviewed after evolving a valid and reliable questionnaire, and determining the sample size. Univar iate and multivariate logistic regression analysis was applied between demo graphic variables, psychosocial factors, primary delay (defined as delay be tween the first symptom and the seeking of medical advice), secondary delay (interval between the first consultation and presentation at the medical c ollege), tertiary delay (delay in definitive treatment even after being see n at a tertiary care centre) and stage of the disease. Multiple logistic re gression was also carried out. Results. Primary delay ranged from less than a week in 5 (6.3%) patients to more than 1 year in 8 (10%) patients. A linear relationship was found betw een primary and secondary delay (F-statistic p < 0.0152), A majority of pat ients (70.9%) had advanced oral cancer, The stage of cancer at presentation to the hospital was significantly related to primary (G-test 6.3; p < 0.01 21) but not to secondary delay. Multivariate analysis revealed that five va riables, 'ill fated to have cancer', 'cancer a curse', 'non-availability of transport', 'trivial ulcers in mouth are self-limiting' and 'prolonged tre atment renders family stressful' were significant independent predictors of primary delay. Conclusion The identified independent predictors of primary delay should be used to develop the main theme of an educational intervention programme fo r patients with oral cancer.