Patient Interval and Associated Factors in the Diagnostic Journey of Oral Cancer: A Hospital-Based Cross-Sectional Study from Kerala, India

Document Type : Research Articles


Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.


Background: The incidence of oral cancer is increasing in south-central Asia. Though it can be detected early, most cases were reported in late stages, resulting in a poor prognosis. Reducing the patient interval will facilitate early diagnosis and better disease survival.  The paucity of research on the patient interval in oral cancer has limited our ability to design and evaluate programs for early diagnosis. Methods: The study was conducted to identify the duration of patient interval and associated factors in oral cancer. Patients with oral cancer reporting at a tertiary cancer center during the study period were interviewed using validated data collection tools. The ‘Aarhus statement’ guidelines were followed in designing and reporting the study. Results: Among the 261 participants, 54% reported a patient interval of more than 90 days. The median (IQR) patient interval was 92 (38-168) days. In the multivariate binary logistic regression model, those who approached healthcare facilities due to pain (OR, 8.3, 95% CI, 2.9 to 23.4) were more likely to have a patient interval of more than 90 days over those who came due to insistence by family. Smoking status (Current smoker vs. never smoker) at the time of diagnosis (OR, 2.518, 95% CI, 1.3 to 4.7), Stage of cancer (late vs. early) of participants (OR, 2.62, 95% CI, 1.3 to 5.2), and time of travel (>30 minutes vs. ≤ 10 minutes) to health care facility (OR 5.8, 95% CI, 1.6 to 21.7) were the other significant predict8  6766667ors for the patient interval of more than 90 days. Conclusion: Patient interval in oral cancer can be reduced by improving symptom awareness, abstinence from tobacco use, and facilitating access to health care facilities. The double burden of tobacco use in oral cancer, as it increases the risk of disease occurrence and delays symptom presentation, needs serious policy considerations in the context of cancer prevention. 


Main Subjects

Volume 22, Issue 10
October 2021
Pages 3143-3149
  • Receive Date: 11 March 2021
  • Revise Date: 19 September 2021
  • Accept Date: 26 October 2021
  • First Publish Date: 26 October 2021