{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:30:02Z","timestamp":1786426202311,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To synthesize barriers associated with delays in the diagnosis and initiation of treatment of oral cancer across high\u2010income countries (HICs) and low\u2010 and middle\u2010income countries (LMICs) contexts, aligned with the\n                      <jats:italic>Aarhus<\/jats:italic>\n                      diagnostic\u2013therapeutic intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic literature search was conducted in PubMed\/MEDLINE, Scopus, Web of Science, Embase, and ProQuest. Observational, qualitative, and mixed\u2010methods studies reporting patient\u2010reported perceptions or system\u2010level barriers affecting the diagnostic\u2010therapeutic pathway and associated with diagnostic or treatment delays in adult oral cancer were included. Data were narratively synthesized, and identified barriers were semantically standardized and mapped to the\n                      <jats:italic>Aarhus<\/jats:italic>\n                      intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen studies were included. Barriers were categorized into psychosocial, symptom appraisal, health literacy, structural, professional\u2010related, and organizational domains. Studies focusing on the patient interval most frequently reported psychosocial and appraisal\u2010related barriers. Studies examining diagnostic, composite, or total intervals more commonly identified professional\u2010related and organizational barriers. Studies from LMICs more frequently addressed extended segments of the care pathway and reported nonbiomedical management strategies, health literacy\u2013related barriers, and professional or structural barriers beyond the patient interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Delays in oral cancer care reflect an interconnected, trajectory\u2010based process shaped by interacting individual, professional, and system\u2010level factors, supporting the need for integrated interventions across the care continuum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70435","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:02:48Z","timestamp":1786424568000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Barriers to Diagnostic and Treatment Delay in Oral Cancer Across Income Settings: Systematic Review"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0614-8681","authenticated-orcid":false,"given":"Andreza Andrade de","family":"Lima","sequence":"first","affiliation":[{"name":"Oral Histopathology Research Group, Graduate Program in Dentistry, Faculty of Dentistry of Pernambuco (FOP\/UPE) University of Pernambuco  Recife PE Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4963-308X","authenticated-orcid":false,"given":"Raisa","family":"Severino\u2010Lazo","sequence":"additional","affiliation":[{"name":"Oral Histopathology Research Group, Graduate Program in Dentistry, Faculty of Dentistry of Pernambuco (FOP\/UPE) University of Pernambuco  Recife PE Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8929-5137","authenticated-orcid":false,"given":"Tatiana 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