Factors contributing to the late diagnosis of buccopharyngeal carcinoma

Abstract

An observational retrospective study of a consecutive series of 249 patients with diagnosis of buccopharyngeal carcinoma reported at the National Cancer Registry between January 2000 and December 2004, in Camagüey, was conducted. Factors and clinical findings that may contribute to the late diagnosis of the buccopharyngeal carcinoma were retrospectively analyzed. According to sex, age, educational level, and the stage and localization of the disease, the duration and type of the symptoms were studied, as well as the cause of the late diagnosis, by separating the very young from the very old cohorts and from those without risk factors. 38.9 % of the patients were diagnosed in stage III and IV. The radix linguae, the floor of the mouth, gingiva and the retromolar area were the most frequent localizations. 54 % of them presented symptoms at least 4 months before being diagnosed and pain (32 %) was the most common of them. The symptoms lasted from 0 to 52 weeks (an average of 8.6 weeks) for stage I and from 0 to 260 weeks (an average of 19.9 weeks) for stage IV. 50.8 % of the lesions of the anterior region of the floor of the mouth were in stage III/IV in relation to 75.7 % of the retromolar region. 75 % of the patients with low educational level were in stage III/IV compared to 54 % of the patients with a high educational level. 71.3 % of the patients without tobacco/alcohol habits were lately diagnosed. 20 % of the patients visited at least a professional in connection with the disease without being adequately diagnosed and referred. 80 % of the patients were diagnosed as part of the National Program of Oral Cancer Control, though there was a predominance of the passive screening. The low educational level, the posterior localizations of the oral cavity due to accesability questions and the lack of risk factors were important factors in the late diagnosis.