Abstract
Head and neck cancers (HNC) have a poor prognosis and a long treatment delay may have a negative impact on this. Some studies have investigated the determinants of this delay but not in the general population and rarely taking into account socio-economic factors. A high-resolution population-based study about cancer management was conducted, using registries in the north-west of France, on HNC diagnosed between 2008 and 2010. The median time between diagnosis and multidisciplinary team meeting (DMI) (N = 1631) was 14 days (Q1: 7 to Q3: 26). The median time between diagnosis and first treatment (DTI) (N = 1519) was 35 days (Q1: 21 to Q3: 54). When the first treatment was radiotherapy, the interval was 54.5 days (Q1: 40 to Q3: 71). In multivariate analysis, DTI was associated with the type of first treatment and place of treatment. For advanced stage HNC, DTI was associated with comorbidities, topography of the cancer and socio-economic status, underprivileged patients being treated later than privileged ones. Given the French governmental cancer plans which set out to coordinate care pathways via nursing coordinators and to improve the availability of radiotherapy, the waiting times observed in this study still seem long. The optimal care pathway should include adapted social management but the DTI was still longer for underprivileged patients.
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Acknowledgments
We thank the French National Cancer Institute and the Ligue Contre le Cancer of Calvados, Manche, Nord and Somme which provided financial support for this study. We thank the ENT specialists, maxillofacial surgeons, oncologists, pathologists, doctors of the health insurance funds and patient administrative database, the multidisciplinary committees, the medical secretaries and archivists of Calvados, Manche, Nord and Somme.
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This study was funded by the French National Cancer Institute and the Ligue Contre le Cancer of Calvados, Manche, Nord and Somme.
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The authors declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was authorised by the CNIL (the French national data protection agency)—no. 907276. For this type of study, formal consent is not required.
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Guizard, AV., Dejardin, O., Launay, L. et al. What are the real waiting times for therapeutic management of head and neck cancer: a study in the general population in the north-west of France. Eur Arch Otorhinolaryngol 273, 3951–3958 (2016). https://doi.org/10.1007/s00405-016-4056-8
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DOI: https://doi.org/10.1007/s00405-016-4056-8