Diagnostic Patterns and Delays of Head-and-Neck Cancer during Coronavirus Disease 2019 Pandemic: A Single-Center Cross-Sectional Study from South Italy

Since a national lockdown was introduced across Italy in early 2020 in response to coronavirus disease 2019 (COVID-19) pandemic, access to health-care services has been limited or suspended. In this cross-sectional study, we examined the delay in the diagnosis and treatment of newly diagnosed head-and-neck cancer (HNC) patients. A total of 59 sequential patients (30 females and 29 males, age 67±14) with HNC were examined between January and September 2020. The average diagnostic delay detected was 152.53 days±62.02 standard deviation (SD) (median 155, range 36–335). Specifically, the average delay between onset of symptoms and first consultation/start of diagnostic pathway (patient delay, D1) was 97.59 days±54.75 SD (median 98, range 13–212), whereas the time needed to reach a final diagnosis (professional delay, D2) was 54.93 days±46.64 SD (median 33, range 4–186). Forty-six patients underwent treatment (surgery, chemotherapy, and/or radiotherapy) within 18.65 days±13.6 SD (median 16, range 1–53) of receiving a diagnosis (treatment delay, D3). Although diagnostic (D1+D2) and treatment (D3) delays were similar for all disease stages and were in line with pre-pandemic data, majority of patients were diagnosed with advanced HNC. Awareness of patterns and delays of HNC diagnosis during COVID-19 pandemic may inform future decisions involving a restricted access to health care.