Advanced stage head and neck cancer diagnosis: HEADSpAcE consortium health systems benchmarking survey

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.