Advanced Stage Head and Neck Cancer Diagnosis: <scp>HEADSpAcE</scp> Consortium Health Systems Benchmarking Survey
Grant Creaney, Mariél de Aquino Goulart, Alex D. McMahon, Claire Paterson, James McCaul, Sandra Pérdomo, Laura Mendoza, Laia Alemany, Lídia Maria Rebolho Batista Arantes, Paula Andrea Rodriguez Urrego, Tom Dudding, Miranda Pring, Marta Vilensky, Cecilia Cuffini, Silvia López de Blanc, José Carlos de Oliveira, Shahid Pervez, Pierre Saintigny, Mauricio Cuello, Jaroslav Betka, Luís Felipe Ribeiro Pinto, María Paula Curado, Kazem Zendehdel, Lorenzo Richiardi, Maja Popović, José Roberto de Podesta, Sandra Ventorin von Zeidler, Ricardo Rocha, Shaymaa AlWaheidi, Paul Brennan, Shama Virani, Alastair Ross, David I. Conway
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.