Delayed diagnosis of cancer with emphasis on oral cavity cancers.

Delayed diagnosis of cancer and, of oral cavity cancers in particular, is of crucial importance for the clinical management, costs of care and unfavourable outcome. Many scientists have studied the causes of delayed diagnosis to find solution of the problem. However, only few studies of this kind have been performed in Bulgaria, especially for oral cavity cancers. The aim of this overview was to summarize and analyze publications on problems and causes of delayed diagnosis of cancer in general and, of oral cavity cancers in particular. The literature search was made in different databases such as MEDLINE, BIOSIS, INTERNET, etc. More than 100 relevant items of information were extracted but only 22 of them were found suitable and further analyzed. The analysis of the literature has revealed the importance of recognizing the warning signals and causes of delayed diagnosis in cancer in general and in oral cavity cancers in particular. For instance, survival of patients with squamous cell carcinoma of the tongue (Dx:141) was related to delayed diagnosis (20% of patients survive more than 5 years and 71%--only 2 years after diagnosis). The problems of delayed diagnosis in patients with multiple neoplasm of the oral cavity (Dx:143-145) and with nasopharyngeal carcinoma (Dx:146-149) were also discussed (96.6% of patients were in stage III at diagnosis). This overview has summarized problems in and stressed the main aspects of delayed diagnosis of cancer in general. It has also denoted hints in delayed diagnosis of cancer of the oral cavity and their relevance to the clinical management, outcome and costs of care for such patients. The latter has been considered of primary importance for general practitioners, dentists and specialists in public health medicine.