Grant: Operating Grant

Cancers of the mouth can be very debilitating, causing problems with swallowing and speaking and treatments that are disfiguring. These cancers can be found early with an oral examination making them as easy to find as skin cancer. Unfortunately, due to low rates of such examinations and patients who delay seeing a doctor about their symptoms (usually a sore in the mouth), about 40% of patients are diagnosed with advanced disease, which is very difficult to cure. Most previous research has recorded the number of days that patients waited before seeking help for symptoms and the number of days between first seeing a doctor and the final diagnosis. Generally, researchers have found that the delay created by the patient is much longer than the delay created by the 'system'. There is very little information about why the delay happens. In this study, we will ask patients to tell us about what happened during the time between noticing symptoms and seeking a doctor's appointment. In particular, we are interested in knowing whether knowledge about oral cavity cancer, and/or a willingness to get information about oral cavity cancer, and/or the advice recieved from family and friends influenced the amount of time that the patient says they waited until calling for a doctor (or dentist) appointment. Separately, we will also investigate whether these same factors are associated with the size of the tumour, which is an objective measure of the amount of time that passed between the presence of symptoms and the diagnosis of the mouth cancer. It is extremely troubling that so many patients have advanced, difficult to cure disease. Very little is understood about why this is happening and the potential to improve cure rates if we can improve the timeliness of diagnoses is enormous. Our results may point to the need for more education about mouth cancer symptoms for people who are at high risk of the disease and for their friends and family.