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Reducing Treatment Deferral in Head and Neck Cancer Patients: A Quality Improvement Study
Vijayakanth Subramanian1, Bharath V S S K Talagadadeevi1, Subhadra Goala2
1Department of Head and Neck Surgical Oncology, Cachar Cancer Hospital and Research Centre, Silchar, Assam, India.
Indian Journal of Palliative Care
|June 3, 2026
Summary
A quality improvement initiative in India significantly reduced head and neck cancer treatment deferrals from 40% to 18% in six months. Targeted interventions addressed financial and logistical barriers, improving patient compliance in resource-limited settings.
Area of Science:
- Oncology
- Public Health
- Health Services Research
Background:
- Head and neck cancer (HNC) presents a substantial health challenge in India, exacerbated by high treatment deferral rates.
- Treatment deferral in resource-constrained environments is influenced by complex sociocultural, economic, and logistical factors, leading to suboptimal patient outcomes.
Purpose of the Study:
- To systematically reduce the treatment deferral rate for head and neck cancer patients at Cachar Cancer Hospital and Research Centre (CCHRC).
- The initiative aimed to decrease the deferral rate from 40% to 20% within a six-month period through a quality improvement program.
Main Methods:
- A mixed-methods approach was utilized under the EQuIP India 2022 program.
- Root cause analysis identified financial barriers, logistical issues, and psychological factors as primary drivers of deferral.
- Interventions included financial aid, motivation programs, workshops, and enhanced communication, with weekly progress monitoring.
Main Results:
- The quality improvement initiative successfully reduced the HNC treatment deferral rate from 40% to 18% within six months.
- Pareto analysis revealed financial constraints and patient's family's income dependency as critical factors.
- Targeted interventions like financial assistance, caregiver support, and patient navigation improved compliance and engagement.
Conclusions:
- Data-driven, targeted interventions are crucial for mitigating treatment deferrals in head and neck cancer care.
- Systemic improvements, including robust financial support and awareness campaigns, are essential for ensuring timely cancer treatment in underserved regions.
