Sánchez-Ortega H, Varela-Centelles P, Seoane J, López-Cedrún JL, Bilbao-Alonso A, García-Caballero L, Blanco-Hortas A, Seoane-Romero JM. Patient delay in oral cancer in North-Western Spain: Where do we stand?. Med Oral Patol Oral Cir Bucal. 2026. Jun 1;31 (5):e631-7.

doi:10.4317/medoral.28246

https://dx.doi.org/doi:10.4317/medoral.28246


1. World Health Organization. Data visualization tools for exploring the global cancer burden in 2022. Geneva: WHO; 2026. [Accessed 2026-02-08]. Available from: https://gco.iarc.who.int.


 

2. Lu DN, Zhang WC, Lin YZ, Zhang YN, Shao CY, Zheng CM, Ge MH, Xu JJ. The incidence trends of oral cancers worldwide from 1988 to 2012 and the prediction up to 2030. Head Neck. 2023 Sep;45(9):2394-2412.
https://doi.org/10.1002/hed.27443
PMid:37417818


 

3. Wu J, Chen H, Liu Y, Yang R, An N. The global, regional, and national burden of oral cancer, 1990-2021: A systematic analysis for the Global Burden of Disease Study 2021. J Cancer Res Clin Oncol. 2025 Jan 28;151(2):53.
https://doi.org/10.1007/s00432-025-06098-w
PMid:39875744 PMCid:PMC11775039


 

4. Gangane NM, Ghongade PV, Patil BU, Atram M. Oral cavity cancer incidence and survival trends: A population-based study. J Cancer Res Ther. 2024 Jul 1;20(5):1446-1452.
https://doi.org/10.4103/jcrt.jcrt_2720_22
PMid:38261454


 

5. Silverman S, Kerr AR, Epstein JB. Oral and pharyngeal cancer control and early detection. J Canc Educ. 2010 Sep;25(3):279-281.
https://doi.org/10.1007/s13187-010-0045-6
PMid:20204575 PMCid:PMC2933804


 

6. Zanoni DK, Montero PH, Migliacci JC, Shah JP, Wong RJ, Ganly I, Patel SG. Survival outcomes after treatment of cancer of the oral cavity (1985-2015). Oral Oncol. 2019 Mar;90:115-121.
https://doi.org/10.1016/j.oraloncology.2019.02.001
PMid:30846169 PMCid:PMC6417804


 

7. Neal RD, Tharmanathan P, France B, Din NU, Cotton S, Fallon-Ferguson J, et al. Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes? Systematic review. Br J Cancer. 2015 Mar 31;112 Suppl1:S92-107.
https://doi.org/10.1038/bjc.2015.48
PMid:25734382 PMCid:PMC4385982


 

8. Gómez I, Seoane J, Varela-Centelles P, Diz P, Takkouche B. Is diagnostic delay related to advanced-stage oral cancer? A meta-analysis. Eur J Oral Sci. 2009 Oct;117(5):541-546.
https://doi.org/10.1111/j.1600-0722.2009.00672.x
PMid:19758250 PMCid:PMC11365049


 

9. Seoane J, Takkouche B, Varela-Centelles P, Tomás I, Seoane-Romero JM. Impact of delay in diagnosis on survival to head and neck carcinomas: A systematic review with meta-analysis. Clin Otolaryngol. 2012 Apr;37(2):99-106.
https://doi.org/10.1111/j.1749-4486.2012.02464.x
PMid:22429704


 

10. Pack GT, Gallo JS. The culpability for delay in treatment of cancer. Am J Cancer. 1938;33:443-462.


 

11. Weller D, Vedsted P, Rubin G, Walter FM, Emery J, Scott S, Campbell C, Andersen RS, Hamilton W, Olesen F, Rose P, Nafees S, van Rijswijk E, Hiom S, Muth C, Beyer M, Neal RD. The Aarhus statement: Improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012 Mar 27;106(7):1262-1267.
https://doi.org/10.1038/bjc.2012.68
PMid:22415239 PMCid:PMC3314787


 

12. Varela-Centelles P, López-Cedrún JL, Fernández-Sanromán J, Seoane-Romero JM, Santos de Melo N, Álvarez-Nóvoa P, Gómez I, Seoane J. Key points and time intervals for early diagnosis in symptomatic oral cancer: A systematic review. Int J Oral Maxillo-fac Surg. 2017 Jan;46(1):1-10.
https://doi.org/10.1016/j.ijom.2016.09.017
PMid:27751768


 

13. Walter F, Webster A, Scott S, Emery J. The Andersen Model of Total Patient Delay: A systematic review of its application in cancer diagnosis. J Health Serv Res Policy. 2012 Apr;17(2):110-118.
https://doi.org/10.1258/jhsrp.2011.010113
PMid:22008712 PMCid:PMC3336942


 

14. Varela-Centelles P, Seoane J, Lopez-Cedrun JL, Fernandez-Sanroman J, García-Martin JM, Takkouche B, Alvarez-Novoa P, Seoane-Romero JM. The length of patient and primary care time interval in symptomatic oral cancer. A quantitative systematic review. Clin Otolaryngol. 2018 Feb;43(1):164-171.
https://doi.org/10.1111/coa.12919
PMid:28627802 PMCid:PMC11527597


 

15. Kumar S, Heller RF, Pandey U, Tewari V, Bala N, Oanh KT. Delay in presentation of oral cancer: A multifactor analytical study. Natl Med J India. 2001 Jan-Feb;14(1):13-7.
PMid:11194185


 

16. Sargeran K, Murtomaa H, Safavi SM, Teronen O. Delayed diagnosis of oral cancer in Iran: Challenge for prevention. Oral Health Prev Dent. 2009;7(1):69-76.
PMid:19274366


 

17. Varela-Centelles P, López-Cedrún JL, Fernández-Santromán J, Álvarez-Nóvoa P, Luaces-Rey R, Pombo-Castro MJ, López-Jornet MP, Seoane J. Assessment of time intervals in the pathway to oral cancer diagnosis in north-westerm Spain. Relative contribution of patient interval.Med Oral Patol Oral Cir Bucal. 2017 Jul 1;22(4):e478-e483.
https://doi.org/10.4317/medoral.21676
PMid:28578373 PMCid:PMC5549521


 

18. Fernández-Martínez NF, Petrova D, Špacírová Z, Barrios-Rodríguez R, Pérez-Sayáns M, Martín-delosReyes LM, Pérez-Gómez B, Rodríguez-Barranco M, Sánchez MJ. The duration of intervals on the oral cancer care pathway and implications for survival: A systematic review and meta-analysis. Front Public Health. 2023 Aug 8;11:1183244.
https://doi.org/10.3389/fpubh.2023.1183244
PMid:37614446 PMCid:PMC10442570


 

19. Scott SE, Grunfeld EA, McGurk M. Patient's delay in oral cancer: A systematic review. Community Dent Oral Epidemiol. 2006 Oct;34(5):337-343.
https://doi.org/10.1111/j.1600-0528.2006.00290.x
PMid:16948672


 

20. Arboleda LPA, de Abreu M, Pinto A, Moyses RA, Warnakulasuriya S, Conway DI, Virani S, Santos-Silva AR, Curado MP. Head and Neck Cancer Patients' Health Literacy: A Systematic Review and Meta-Analysis. Head Neck. 2026 Jun;48(6):1461-1472.
https://doi.org/10.1002/hed.70154
PMid:41489275


 

21. Abdo EN, Garrocho A de A, Barbosa AA, Oliveira EL, Franca-Filho L, Negri SL, Pordeus IA. Time elapsed between the first symptoms, diagnosis and treatment of oral cancer patients in Belo Horizonte, Brazil. Med Oral Patol Oral Cir Bucal. 2007 Nov 1;12(7):E469-473.
Pmid:17909515


 

22. Varela-Centelles PI, López DP, López-Cedrún JL, García-Rozado Á, Baz PC, Romero-Méndez A, Seoane J. Impact of the Presenting Symptom on Time Intervals and Diagnostic Routes of Patients with Symptomatic Oral Cancer. Cancers (Basel). 2021 Oct 14;13(20):5163.
https://doi.org/10.3390/cancers13205163
PMid:34680312 PMCid:PMC8533728


 

23. Hollows P, McAndrew PG, Perini MG. Delays in the referral and treatment of oral squamous cell carcinoma. Br Dent J. 2000 Mar 11;188(5):262-265.
https://doi.org/10.1038/sj.bdj.4800449
PMid:10758688

 

24. Peacock ZS, Pogrel MA, Schmidt BL. Exploring the reasons for delay in treatment of oral cancer. J Am Dent Assoc. 2008 Oct;139(10):1346-1352.
https://doi.org/10.14219/jada.archive.2008.0046
PMid:18832270

 

25. Keinänen A, Uittamo J, Snäll J. Do we recognize oral cancer? Primary professional delay in diagnosis of oral squamous cell carcinoma. Clin Oral Investig. 2024 Feb 3;28(2):131.
https://doi.org/10.1007/s00784-024-05515-7
PMid:38308109

 

26. Lyratzopoulos G, Abel GA, McPhail S, Neal RD, Rubin GP. Measures of promptness of cancer diagnosis in primary care: Secondary analysis of national audit data on patients with 18 common rarer cancers. Br J Cancer. 2013 Feb 19;108(3):686-690.
https://doi.org/10.1038/bjc.2013.1
PMid:23392082 PMCid:PMC3593564

 

27. Grafton-Clarke C, Chen KW, Wilcock J. Diagnosis and referral delays in primary care for oral squamous cell cancer: A systematic review. Br J Gen Pract. 2019 Feb;69(679):e112-e126.
https://doi.org/10.3399/bjgp18X700205
PMid:30455220 PMCid:PMC6355296

 

28. Seoane J, Otero-Rico A, López-Cedrún JL, Varela-Centelles P. Shorter specialist time intervals are associated with advanced stage on symptomatic oral cancer. Oral Dis. 2018 Mar;24(1-2):112-114.
https://doi.org/10.1111/odi.12754
PMid:29480638

 

29. Lauritzen BB, Jensen JS, Grønhøj C, Wessel I, von Buchwald C. Impact of delay in diagnosis and treatment-initiation on disease stage and survival in oral cavity cancer: A systematic review. Acta Oncol. 2021 Sep;60(9):1083-1090.
https://doi.org/10.1080/0284186X.2021.1931712
PMid:34043480 PMCid:PMC11527597

 

30. Tirelli G, Boscolo-Rizzo P, Pelloso L, Gardenal N, Giudici F, Marcuzzo AV, Tofanelli M. Impact of time-to-surgery on survival and quality of life in oral cancer. Am J Otolaryngol. 2023 Nov-Dec;44(6):103984.
https://doi.org/10.1016/j.amjoto.2023.103984
PMid:37437337