Symptom-to-Diagnosis Interval, Treating-Center Context, and Survival in Nasopharyngeal Carcinoma in Nonendemic Northern China: A Multicenter Real-World Cohort Study
In brief
Three-month diagnostic delay increases death risk by roughly one-third in nasopharyngeal cancer
In a real-world cohort of 1,022 non-metastatic patients, more than half waited over three months from first symptom to diagnosis, which doubled the odds of presenting with stage III-IVA disease and raised five-year mortality by about 30% after adjusting for stage. Survival also varied by treating hospital, highlighting the need for quicker referral pathways and attention to center expertise.
- Journal
- Head & neck (Q1)
- Published
- 27 August 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Qi An, Qingxin Wang, Yubing Qian, Minghan Qiu, Shenglin Zhang, Xinyu Zhao, et al.
- PMID
- 42657960
- DOI
- 10.1002/hed.70449
Why clinicians should know about it
- Picked for Otorhinolaryngology (paper of the day, 30 August 2026): Prognostic analysis of imaging iENE in HPV‑positive OPC
Abstract
BACKGROUND: In nonendemic northern China, symptom recognition prompts diagnostic evaluation for nasopharyngeal carcinoma. METHODS: We analyzed 1022 patients with nonmetastatic nasopharyngeal carcinoma treated with definitive-intent intensity-modulated radiotherapy. The symptom-to-diagnosis interval extended from first symptom onset to pathological diagnosis. Logistic and Cox models assessed stage and survival; treating-center analyses used a 2016-2022 common-window cohort. RESULTS: Stages III-IVA disease occurred in 807 patients (79.0%), and 576 (56.4%) had intervals > 3 months. Intervals > 3 months were associated with Stages III-IVA disease (OR 2.52, 95% CI 1.85-3.45) and mortality (HR 1.62, 95% CI 1.28-2.06); after AJCC-stage adjustment, HR 1.29 (95% CI 1.00-1.67). Treatment at participating tertiary general hospitals was associated with higher mortality (HR 1.46, 95% CI 1.07-1.98). Exploratory model-standardized analyses yielded predicted 5-year death differences of 25.99 (4.22-47.68) and 51.47 (26.27-75.50) for treating-center and interval scenarios. CONCLUSIONS: Longer intervals were associated with advanced stage and poorer survival; survival differed by treating-center context.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.