Abstract
Background
Globally, most people with head and neck cancers (HNCs) are diagnosed with advanced-stage disease. HNC diagnostic stage has multifactorial explanations, with the role of health system factors not yet fully investigated.
Methods
HNC centres (n = 18) from the HEADSpAcE Consortium were surveyed via a bespoke health system questionnaire covering a range of factors. Centres were compared using the least square means for the presence/absence of each health system factor to their proportion of advanced-stage HNC.
Results
Health system factors associated with lower proportion in advanced-stage diagnosis were formal referral triaging (14%, 95% CI-0.26, −0.03), routine monitoring of time from referral to diagnosis (16%, 95% CI-0.27, −0.05), and fully publicly funded systems (17%, 95% CI-0.29, −0.06). Several health systems factors had no routinely available data.
Conclusions
Through identifying and monitoring health systems factors associated with lower proportions of advanced stage HNC, interventions could be developed, and systems redesigned, to improve early diagnosis.
Globally, most people with head and neck cancers (HNCs) are diagnosed with advanced-stage disease. HNC diagnostic stage has multifactorial explanations, with the role of health system factors not yet fully investigated.
Methods
HNC centres (n = 18) from the HEADSpAcE Consortium were surveyed via a bespoke health system questionnaire covering a range of factors. Centres were compared using the least square means for the presence/absence of each health system factor to their proportion of advanced-stage HNC.
Results
Health system factors associated with lower proportion in advanced-stage diagnosis were formal referral triaging (14%, 95% CI-0.26, −0.03), routine monitoring of time from referral to diagnosis (16%, 95% CI-0.27, −0.05), and fully publicly funded systems (17%, 95% CI-0.29, −0.06). Several health systems factors had no routinely available data.
Conclusions
Through identifying and monitoring health systems factors associated with lower proportions of advanced stage HNC, interventions could be developed, and systems redesigned, to improve early diagnosis.
| Original language | English |
|---|---|
| Journal | Head and Neck |
| Early online date | 24 Feb 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 24 Feb 2025 |
Bibliographical note
Publisher Copyright:© 2025 The Author(s). Head & Neck published by Wiley Periodicals LLC.
