Liao DZ, Schlecht NF, Rosenblatt G, et al. - Researchers analyzed the relationship of delayed initiation of treatment with overall survival and recurrence outcomes among head and neck squamous cell carcinoma (HNSCC) patients, analyzed factors anticipating delayed initiation of treatment, and identified specific reasons for delayed initiation of treatment. The sample consisted of 956 patients treated with primary HNSCC, identified by the Montefiore Medical Center Cancer Registry between February 8, 2005, and July 17, 2017. According to this retrospective cohort study, the median time to treatment initiation (TTI) was 40 days in 956 HNSCC individuals (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. An association was found between delaying TTI beyond 60 days and reduced overall survival and increased HNSCC recurrence. Identifying predictive factors and reasons for the delay in treatment will aid target at-risk patients and facilitate hospital intervention with underserved urban populations.