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Comparing the Type of Delays in Oral Cancer: A Systematic Review and Meta-Analysis

Syed Ammar Sajjad*

Aims: This meta-analysis aims to explore the types of delays which are generally found in the patients suffering from oral cancer at different point times from onset of symptoms to initiation of appropriate treatment. It compares the mean delay time of head and neck cancer patients from different studies.

Methods: A comprehensive systematic literature search was carried out to find studies published from 2000 to 2020 from different database. We searched online databases z- library, Google Scholar PubMed, and Embase for articles which were dealing with oral (head and neck cancer). The language of literature included is English. We have used three delays classified as primary, secondary and tertiary delay. On the basis of inclusion and exclusion criteria, studies are included in the study. Studies having mean, SD and median delay time were considered. For the conduction of meta-analysis, forest plot is constructed and the mean delay in any type of delay is compared with one another.

Results: Overall, 10 studies comprising of 4344 patients met our inclusion criteria and are included in our study. The studies in which primary delay data was available were 9 comprising of 3769 cases. For secondary delay, 8 studies and 3864 cases were taken in which data for mean, range and median delay was available. For tertiary delay secondary 5 studies and 2344 cases were taken in which data for mean, sd, range and median delay was available. The mean for primary delay was 55.91, for secondary delay was 33.39 and for tertiary delay was 55.17. The Forest Plot for the comparisons of Primary vs Secondary, Secondary vs Tertiary and Primary vs Tertiary is also plotted to compare between the means of the different delays.

Conclusions: It is clear from the above results that: Primary Delay > Tertiary Delay > Secondary Delay. Efforts should be made in making the people aware about the symptoms of oral cancer and the factors causing it. People should be educated about the health outcomes and results which are caused due to delay in consulting with the specialist as soon as possible.