OBJECTIVES: Head and Neck Squamous Cell Cancer (HNSCC) is a significant healthcare concern in Colombia, where information about the timeliness of diagnosis and treatment is incomplete given the fragmentation of the healthcare system. This study aimed to determine the patient journey of HNSCC in Colombian cancer centers, focusing on treatment patterns, diagnosis intervals, and differences between the two main health insurances: contributory (CR) and subsidized regimes (SR)

METHODS: A retrospective cohort study was conducted, reviewing medical records for HNSCC patients from five institutions between January 1st, 2015, and December 31st, 2019. Time intervals defined as: I) Diagnosis Interval (DI) time from patient’s first consultation to definitive anatomopathological diagnosis, and II) Treatment Interval (TI) time from confirmatory diagnosis to initiation of treatment.

RESULTS: 91 patients were included. 58% (n=53) were affiliated to CR, 32% (n=29) to SR, and 10% (n=9) under another regime. Tumor anatomic locations: oropharynx (46.2%), larynx (39.6%), and oral cavity (14.3%). 33% (n=30) of cases classified as stage IV-IVC, 22% (n=20) stage III, 25% (n=23) stages I-II, 1% stage 0 (n=1), and 19% (n=17) unknown stage.

Treatment patterns by modality were 34% (n=54) radiotherapy, 23% (n=37) chemotherapy, 18% (n=28) surgery, 18% (n=29) chemotherapy plus radiotherapy, 4% (n=7) immunotherapy, and 3% (n=1) cetuximab.

The overall median DI was 120 (IQR: 199) days, and the overall median TI was 73 (IQR: 95) days. Patients from CR had higher median DI compared to SR (124 vs. 84 days), while the TI for SR was higher than CR (78 vs. 55 days).

CONCLUSIONS: While the treatment patterns were aligned with the established guidelines, the DI and TI showed delays, particularly affecting to the CR, highlighting the need of actions that improve diagnosis and treatment in HNSCC. Future research should focus on exploring the causes of these delays and evaluating targeted interventions in reducing them.