Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 6, June, p. 735–743

doi: 10.17219/acem/116753

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Oral cancer: The first symptoms and reasons for delaying correct diagnosis and appropriate treatment

Monika Rutkowska1,A,B,C,D,E,F, Sylwia Hnitecka2,A,B,C,D,E,F, Marek Nahajowski3,A,B,C,D,E,F, Marzena Dominiak4,E,F, Hanna Gerber5,B,E,F

1 Clinical Department of Maxillofacial Surgery, 4th Military Clinical Hospital, Wrocław, Poland

2 Dental Clinic, 4th Military Clinical Hospital, Wrocław, Poland

3 Private dental practice, Wrocław, Poland

4 Department of Oral Surgery, Wroclaw Medical University, Poland

5 Department of Maxillofacial Surgery, Wroclaw Medical University Hospital, Poland

Abstract

Background. The first symptoms of oral cancer are nonspecific. They raise suspicions of other, less serious conditions. Treatment of oral cancer is challenging, and the time of its detection and the implementation of appropriate therapy affect the prognosis.
Objectives. To identify predisposing factors, symptoms, time of, and reasons for delays in the diagnosis and appropriate treatment of oral cancer.
Material and Methods. This retrospective analysis includes patients who were hospitalized with a diagnosis of carcinoma at the Clinical Department of Maxillofacial Surgery at the 4th Military Clinical Hospital and Polyclinic in Wrocław, Poland, between 2008 and 2018, and at the Department of Maxillofacial Surgery at Wroclaw Medical University Hospital between 2010 and 2018. The analysis took into account the data obtained from the patients’ medical records.
Results. This study comprised 305 patients (112 female; 36.7% and 193 male; 63.3%). The most frequent diagnosis was squamous cell carcinoma (N = 294; 96.4%). The floor of the mouth was the most frequent primary site (N = 103; 33.8%), followed by the anterior 2/3 of the tongue (N = 94; 30.8%) and lower gingiva (N = 43; 14.1%). A significant percentage were reported at an advanced stage (73.5% in stages III and IV combined). The reasons for the late-stage diagnoses depended on the patients (40.6%), the doctors (24.9%) or both (10.8%). Only 47.5% of patients reported because of the initial symptom noticed. Nearly half of the patients reported after 3–6 months of observing symptoms, usually to a general practitioner (GP; 35.7%) or a dentist (31.8%).
Conclusion. The oncological awareness of patients and healthcare professionals is an essential issue. Doctors often recommend inappropriate treatment, sometimes without monitoring its effectiveness. Dentists should consider cancer in the differentiation of clinical manifestations of other oral disorders.

Key words

oral diseases, head and neck cancer, oral cancer

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