Regional guideline for diagnosis and treatment of squamous cell carcinoma of the lip: what is the level of compliance?

Objective: To investigate to what extent physicians comply with a regional guideline for the diagnosis, staging, treatment and follow-up of patients with squamous cell carcinoma of the lower lip.
Design: Retrospective analysis of data from the medical records of 248 patients diagnosed with squamous cell carcinoma of the lower lip during the period 1989-1997.
Setting: Comprehensive Cancer Centre of the Northern region of the Netherlands.
Study Participants: The data were collected by this Centre for the regional population-based cancer registry.
Results: Overall compliance with the separate guidelines varied between 4 and 80%. For diagnosis and staging, the guideline was followed for 4-70% of patients. The type of treatment in relation to age conformed to the guideline in 34% of cases. Of the 208 surgically-treated patients, treatment was performed in accordance with the guidelines in 92 (44%) patients, compared with seven out of 18 (39%) patients who received radiotherapy. Follow-up in accordance with the guideline was 11% in the first year, 9% in the second year and 21% in the third year.
Conclusion: Only a minority of patients with squamous cell carcinoma of the lower lip, a rare rumour, were managed according to the available regional guideline. Regular review of both the guideline and its implementation is necessary in order to optimize its use.