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.