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Scientific Oral Presentation

Head and Neck Surgery

Predictors Of diagnostic Delay in head and Neck Cancer

Monday, October 19, 2026
4:12 PM - 4:18 PM PT
Location: West Exhibit Hall A, Learning Zone 3
Disclosure(s):
Laiken E. Griffith, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Previous studies have shown significant variation in the five-year survival rate of head and neck squamous cell carcinoma (HNSCC) depending on stage at presentation with a survival rate of 86.6% for localized disease, decreasing to less than 20% for metastatic disease. Unfortunately, 51% of new diagnoses are locally advanced, and another 15% are metastatic at the time of diagnosis. This study aimed to investigate predictors of diagnostic delays in HNSCC patients.

Methods: A retrospective review of subjects who were diagnosed and surgically treated for HNSCC at a single academic institution between 2021-2022 was performed. A moderate delay was defined as > 3 months and severe delay defined as > 6 months from symptom onset to date of biopsy. Patients with no recorded date of symptom onset or previous diagnosis of head and neck cancer were excluded. Associations between age, race, sex, marital status, tobacco use, presenting symptom, and referring provider and time to diagnosis were analyzed using a multivariable logistic regression.

Results: The study included 237 patients (mean age = 62.8 years, 64.6% male). Moderate (59.1% of patients) and severe diagnostic delays (33.3% of patients)  were common. Presenting symptom was a significant predictor of moderate (p = 0.030) and severe (p = 0.036) delays, with patients presenting with dysphagia/dysphonia more likely to experience both moderate (OR = 13.029, 95% CI: 2.391-70.984) and severe (OR = 8.762, 95% CI: 2.293-33.487) delays compared to those presenting with a neck mass. Referral by an oral surgeon, dentist, or otolaryngologist was associated with decreased odds of severe delay (OR = 0.152, 95% CI: 0.030-0.762, OR = 0.218, 95% CI: 0.049-0.976, respectively) compared to referral by PCP.

Conclusions: Diagnostic delays are common in HNSCC patients. Referral by an otolaryngologist, oral surgeon, or dentist was associated with lower odds of diagnostic delay compared to referral by PCP. Presenting symptoms of visible lesion, pain, or dysphonia/dysphagia were associated with increased odds of delay compared to presentation with a neck mass.