Time-to-Treatment of Oral Cancer and Potentially Malignant Oral Disorders: Findings in Malaysian Public Healthcare

• Published in: Dentistry journal 2022-10, Vol.10 (11), p.199
• Main Authors: Raman, Sivaraj, Shafie, Asrul Akmal, Abraham, Mannil Thomas, Kiong, Shim Chen, Maling, Thaddius Herman, Rajendran, Senthilmani, Cheong, Sok Ching
• Format: Article
• Language: English
• Subjects: access; Cancer; delays; Disorders; Family income; Health care; Health services; Intervals; Lesions; Medical records; Medical screening; Mortality; Normal distribution; Oral cancer; Patients; precancerous conditions; public hospitals; Sample size; Sociodemographics; time-to-treatment
• ISSN: 2304-6767; 2304-6767
• DOI: 10.3390/dj10110199

This study aims to evaluate the time-to-treatment of oral cancer and potentially malignant oral disorders (PMOD) in a Malaysian public healthcare setting while exploring its contributing factors. It consists of (1) a cross-sectional patient survey to quantify time to seek care and barriers faced, and (2) a retrospective medical record abstraction to determine treatment and management intervals. Time intervals were aggregated and analyzed by their primary contributor—patient, professional, or healthcare system. The average total time-to-treatment of the 104 patients investigated was 167 days (SD = 158). This was predominantly contributed by the patient interval of 120 days (SD = 152). In total, 67.0% of patients delayed their visit to primary healthcare centers because they assumed the lesions were not dangerous or of concern. Additionally, there was a significant difference between patients ‘facing’ and ‘not facing’ difficulties to seek care, at 157 vs. 103 days (p = 0.028). System and professional delays were comparably shorter, at 33 days (SD = 20) and 10 days (SD = 15) respectively. Both demonstrated a significant difference between oral cancer and PMOD, at 43 vs. 29 days (p < 0.001) and 5 vs. 17 days (p < 0.001). The findings reiterate the need to reform current initiatives to better promote early lesion recognition by patients and implement strategies for the elimination of their access barriers.