The duration of intervals on the oral cancer care pathway and implications for survival: a systematic review and meta-analysis Fernández-Martínez, Nicolás Francisco Barrios Rodríguez, Rocío Martín de los Reyes, Luis Miguel Rodríguez Barranco, Miguel Sánchez Pérez, María José Oral cancer Intervals Early diagnosis TNM staging Survival This work was supported by the Spanish Association Against Cancer [Asociación Española contra el Cáncer, PROYE20023SANC “High resolution study of social inequalities in cancer (HiReSIC)”], the Cancer Epidemiological Surveillance Subprogram of the CIBER of Epidemiology and Public Health and the Health Institute Carlos III (VICA), and the Health Institute Carlos III (PI18/01593 “Multilevel population-based study of socioeconomic inequalities in the geographical distribution of cancer incidence, mortality and net survival”). DP was supported by a Juan de la Cierva Fellowship from the Ministry of Science and the National Research Agency of Spain (MCIN/AEI, JC2019- 039691-I, http://doi.org/10.13039/501100011033, Accessed October 4, 2021). The funders had no role in study design, data collection and analysis, the decision to publish, or preparation of the manuscript. The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1183244/full#supplementary-material Introduction: Previous studies measuring intervals on the oral cancer care pathway have been heterogenous, showing mixed results with regard to patient outcomes. The aims of this research were (1) to calculate pooled meta-analytic estimates for the duration of the patient, diagnostic and treatment intervals in oral cancer, considering the income level of the country, and (2) to review the evidence on the relationship of these three intervals with tumor stage at diagnosis and survival. Materials and methods: We conducted a systematic review with meta-analysis following PRISMA 2020 guidelines (pre-registered protocol CRD42020200752). Following the Aarhus statement, studies were eligible if they reported data on the length of the patient (first symptom to first presentation to a healthcare professional), diagnostic (first presentation to diagnosis), or treatment (diagnosis to start of treatment) intervals in adult patients diagnosed with primary oral cancer. The risk of bias was assessed with the Aarhus checklist. Results: Twenty-eight studies reporting on 30,845 patients met the inclusion criteria. The pooled median duration of the patient interval was 47 days (95% CI = 31–73), k = 18, of the diagnosis interval 35 days (95% CI = 21–38),k = 11, and of the treatment interval 30 days (95% CI = 23–53), k = 19. In lower-income countries, the patient and treatment intervals were significantly longer, and longer patient intervals were related to later stage at diagnosis. In studies with a lower risk of bias from high-income countries, longer treatment intervals were associated with lower survival rates. Conclusion: Interval duration on the oral cancer care pathway is influenced by the socio-economic context and may have implications for patient outcomes. 2023-09-22T06:34:35Z 2023-09-22T06:34:35Z 2023-08-08 journal article Fernández-Martínez NF, Petrova D, Špacírová Z, Barrios-Rodríguez R, Pérez-Sayáns M, Martín- delosReyes LM, Pérez-Gómez B, Rodríguez-Barranco M and Sánchez MJ (2023) The duration of intervals on the oral cancer care pathway and implications for survival: a systematic review and meta-analysis. Front. Public Health 11:1183244. [doi: 10.3389/fpubh.2023.1183244] https://hdl.handle.net/10481/84560 10.3389/fpubh.2023.1183244 eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional Frontiers Media