Exploring the Role of Symptom Diversity in Facial Basal Cell Carcinoma: Key Insights into Preoperative Quality of Life and Disease Progression.

Facial basal cell carcinoma (BCC) is the most common skin cancer, yet delays in diagnosis and treatment persist. These delays affect quality of life (QoL), advance disease progression, and increase healthcare burden. This study explores the relationship between symptom diversity, QoL, and care-seeking behaviors, focusing on the impact of symptoms on clinical outcomes and consultation timing. A total of 278 adults with histologically confirmed facial BCC underwent surgical treatment at Vilnius University Hospital from November 2022 to April 2024. The data collected included demographics, tumor characteristics, and self-reported symptoms (pain, bleeding, itching, tumor presence, discomfort, and erosion). Disease-specific QoL was assessed using the Skin Cancer Index. ANCOVA compared QoL across symptom groups, multiple regression analyzed symptom effects on QoL, and logistic regression evaluated care-seeking behavior over time. Cox regression assessed symptom associations with time to medical consultation. The mean time from symptom onset to consultation was 21 months. Tumor presence (27%), erosion (18%), and discomfort (17%) were the most reported symptoms. Discomfort significantly reduced QoL in emotional, social, and appearance domains ( < 0.05). Logistic regression showed tumor presence and pain were associated with earlier care-seeking within 12 months ( < 0.05). Other symptoms, such as bleeding, itching, and erosion, did not significantly influence consultation timing. The findings highlight the need for public education and proactive patient counseling to promote timely intervention and reduce the disease progression.