Changes from 1992 to 2002 in the pretreatment delay for patients with squamous cell carcinoma of larynx or pharynx: A Danish nationwide survey from DAHANCA

Figures & data

Table I.  Patient and tumor characteristics

	1992		2002		All
	n	%	n	%	n	%	Significance
Age
0–60	50	40%	72	44%	122	42%
> 60	76	60%	90	56%	166	58%	n.s
Gender
Male	100	79%	124	77%	224	78%
Female	26	21%	38	24%	64	22%	n.s.
Tumor site
Larynx	81	64%	73	45%	154	53%
Pharynx	45	36%	89	55%	136	46%
Total	126		162		288		n.s.
Stage, pharynx
I	1	2%	4	5%	5	4%
II	7	16%	11	12%	18	13%
III	11	24%	21	24%	32	24%
IV	25	56%	49	55%	74	55%
Unknown	1	2%	4	5%	5	4%
Total	45		89		135		n.s.
Stage, larynx
I	35	43%	24	33%	59	38%
II	18	22%	19	26%	37	24%
III	19	24%	14	19%	33	21%
IV	9	11%	15	21%	24	16%
Unknown	0	0%	1	1%	1	1%
Total	81		73		154		n.s.
Stage, total
I	36	28%	28	17%	54	22%
II	26	20%	30	19%	56	19%
III	30	23%	35	22%	65	22%
IV	35	27%	64	40%	99	34%
Unknown	4	3%	5	3%	9	3%
Total	131		162		293		p = 0.01

Figure 1.  A graphical presentation of a typical patient flow through the health care system in Denmark. First contact is to a general practitioner (GP), otolaryngologist (ENT) or dentist for referral to a head and neck cancer center (ENT center). The ENT center makes the definitive diagnosis and refers the patient for definitive treatment, which will be decided at a multidisciplinary conference.

Table II.  Main time intervals in the pretreatment delay 1992 and 2002. All numbers are in days.

	1992 median days (10–90 percentiles)	2002 median days (10–90 percentiles)	Significance (Mann-Whitney)
Patients delay	63 (5–320)	75 (0–392)	n.s.
Diagnostics	19 (5–106)	18 (8–78)	n.s.
Prepare time	31 (14–54)	46 (29–70)	p < 0.001
Total time in health care	50 (26–131)	70 (42–126)	p < 0.001

Table III.  The extent of diagnostic tests used in the two periods. Information was available in 121–124 patients in 1992, 156–157 patients in 2002.

	Cases (% of all)
	1992 (n = 126)	2002 (n = 162)	Significance (χ^2)
Magnetic Resonance scan (MR)	4 (3%)	26 (17%)	p < 0.001
Computer Tomography scan (CT)	12 (10%)	31 (19%)	p < 0.001
Ultrasound scan (US)	2 (2%)	35 (22%)	p < 0.001
Positron Emission Transduction scan (PET)	0 (0%)	12 (8%)	p < 0.001
CT based dose plan	19 (15%)	120 (74%)	p < 0.001