Diagnostic and treatment time frames
Early diagnosis is a crucial variable in the odds of treatment success
in cancer patients, with numerous studies showing that diagnostic delays
negatively impact survival outcomes. Rygalski et al. retrospectively
evaluated 37730 patients with head and neck cancer included in the
National Cancer Database (NCD), finding that the cut-off point for time
to surgery that had the greatest impact on survival was 67 days11. In another study, Murphy et al. evaluated data
from 51655 patients included in the NCD who received curative-intent
treatment for oral, oropharyngeal, or hypopharyngeal cancer, finding
that time from diagnosis to treatment > 60 days was
consistently associated with a higher risk of death12. In our study, we found a small but non-significant
increase in time from first visit to the MTB meeting (27.9 vs. 33.5
days), in line with the data reported by Kiong et al.8. We also observed a significant increase in time
(from 17.1 to 21.7 days) from presentation to the MTB to treatment
initiation, a finding that is consistent with the data described by
Tevetoglu et al. 10. Similarly, the time from the
first visit to treatment initiation also increased significantly in our
study (44.7 vs. 54.4 days), a finding that contrasts with Teretoglu et
al., who found no significant changes (Kiong et al. did not evaluate
this variable).
Our data show that the percentage of radiological diagnoses performed at
the GPCC was similar in both periods. By contrast, a significantly
greater percentage of patients underwent biopsy in the Covid period
(57.4% vs. 48.6% in the pre-pandemic period). These data show that
although restrictions in non-cancer centres at least partially affected
outpatient diagnostic tests, it had no significant impact on the time
interval to the MTB meeting. However, waiting times for inpatient
treatment differed between the periods, and the restrictions in place at
our centre and other centres could have affected the time from MTB to
treatment 13,14. Another factor that may have
influenced the time to treatment initiation is patient-related concerns
about entering the hospital during the pandemic 15.