{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T04:40:09Z","timestamp":1758861609806,"version":"3.44.0"},"reference-count":17,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCMSA"],"abstract":"<jats:p>Background:\u00a0Delayed presentation of head and neck cancers at Tygerberg Hospital often results in tumour progression and clinical upstaging \u2013 frequently marking the difference between curative and palliative care. This study aimed to identify factors contributing to prolonged time intervals before specialist consultation in South Africa\u2019s public healthcare sector, and to inform potential interventions to address these delays.Methods:\u00a0A cross-sectional, survey-based study was conducted. Patients were recruited weekly, and data were collected through individual interviews. Descriptive statistics were used to analyse responses.Results:\u00a0At initial specialist presentation, 58.9% of patients were diagnosed with stage III\/IV disease, with oral cavity malignancies being most common. Nearly half (47.06%) experienced delays because of inappropriate antibiotic prescriptions and misdiagnoses. The median time from symptom onset to specialist review was 135 days. The most frequently cited patient-related barrier was poor health literacy (57.84%).Conclusion:\u00a0The majority of patients presented with advanced-stage head and neck cancer. Delays were attributed to both clinician-related factors \u2013 such as misdiagnosis and unwarranted antibiotic use \u2013 and patient-related factors, primarily limited health literacy. The observed median delay exceeds international benchmarks, underscoring the need for targeted interventions.Contribution:\u00a0This study highlights the urgent need for earlier referral and specialist assessment of head and neck cancer patients. Findings support the implementation of clinician education, patient awareness initiatives and policy development aimed at reducing diagnostic and referral delays within South Africa\u2019s public healthcare system.<\/jats:p>","DOI":"10.4102\/jcmsa.v3i1.215","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T12:21:18Z","timestamp":1757334078000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of delayed specialist presentation in head and neck cancer to Tygerberg Hospital, Western Cape"],"prefix":"10.4102","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8015-8578","authenticated-orcid":false,"given":"Petrus J.","family":"Vermeulen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5719-8414","authenticated-orcid":false,"given":"Johan","family":"Grobbelaar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2580","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D. 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