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South Asian J Cancer. 2020 Jan-Mar;9(1):38-42. doi: 10.4103/sajc.sajc_26_19.

Demography and treatment pattern of patients with head and neck carcinoma presenting to a tertiary care center in India: Need for urgent decentralization of cancer care.

Author information

1
Department of General Surgery, Forth Valley Royal Hospital, Larbert, Scotland, UK.
2
Department of Head Neck Oncology, Tata Memorial Hospital, Mumbai, India.

Abstract

Aims:

This study aims to report on the demographic profile and treatment pattern of head and neck cancer patients and impact of an early treatment decision on treatment. This study also aims to suggest recommendations to improve treatment compliance.

Methods:

All new patients registered under the head and neck disease management group (DMG) over a period of 3 months at a single center were included. Their demographic details, time to treatment decision, and treatment compliance were determined. The findings were presented to head and neck DMG, and changes were implemented to patient workup with an aim to improve compliance. A reaudit was performed over a period of 3 months and results were compared.

Results:

Two thousand two hundred and forty patients were included in the analysis. Patients with a treatment decision at 1-4 weeks stood at 28.32%, 63.88%, 80.8%, and 89.87%, respectively. Dropout rate was 26%. About 50% of patients planned for surgical intervention could be treated within the institution. After implementation of changes as recommended by DMG, 2418 patients were analyzed and findings were compared to the previous audit. The dropout rate reduced to 17.57%. The number of patients with a treatment decision at 1-4 weeks were 51.26%, 77.42%, 89.46%, and 94.31%, respectively.

Conclusion:

Early treatment decision and referral could significantly improve patient dropout and possibly compliance to treatment. Decentralization of cancer care is urgently needed to manage the high numbers of patients presenting to tertiary care centers. Setting up of new regional cancer centers and increasing infrastructure in the existing centers should be the long-term goals.

KEYWORDS:

Head and neck cancer; patient demography; treatment compliance

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