Liao DZ, Schlecht NF, Rosenblatt G, et al. - In this retrospective cohort study, researchers explored the connection of delayed initiation of treatment with overall survival and recurrence outcomes among patients with head and neck squamous cell carcinoma (HNSCC), analyzed factors predicting delayed initiation of treatment, and identified specific reasons for delayed initiation of treatment. Participants were 956 patients treated with primary HNSCC, identified by the Montefiore Medical Center Cancer Registry between February 8, 2005, and July 17, 2017. Data reported that the median time to treatment initiation (TTI) was 40 days in 956 HNSCC patients (mean [SD] age, 60.8 [18.2] years). Predictors of delayed TTI involved African American race/ethnicity, Medicaid insurance, BMI below 18.5, and initial diagnosis at a different institution. Missed appointments, extensive pretreatment evaluation, and treatment refusal were commonly identified individual reasons for treatment delay. Findings suggested an association of delaying TTI beyond 60 days with reduced overall survival and increased HNSCC recurrence. Identifying predictive factors and reasons for the delay in treatment will help target at-risk patients and facilitate hospital intervention with underserved urban populations.