To determine whether the time to refer head and neck cancer patients to rehabilitation after being admitted varies by sex, age, or year of referral and to determine if there are any correlates with mortality and incidence in Virginia. For use in this retrospective cohort study, data were gathered from 356 head and neck cancer patients admitted to the VCU Medical Center in Richmond, VA from 1988-2000 who were later referred to the Rehabilitation Service at the Massey Cancer Center. The time in days from admission to referral to the rehabilitation service is referred to as days to referral (DTR) and is the primary measure in this study. The data was stratified according to year of referral, sex, and age of the patient and any correlations were analyzed. Finally, data from the SEER database of the National Cancer Institute was used to provide possible correlates between survival and DTR. The mean DTR for males and females combined was 5.3 days while mean DTR for males was 5.5 days and for females, 4.9 days. The differences between the male mean DTR and female mean DTR were not statistically significant. A trend, though not statistically significant, of increased age with decreased DTR in females (P=0.31) and paradoxically increased age with increased DTR for males (P=0.18) was found. There was a statistically significant trend of decreasing DTR over the years of the study for both females and males (P 0.001). Data from the SEER database demonstrated a decrease in mortality in Virginia over the years of the study and when this trend is compared to the trend of decreasing DTR during the same period there is a statistically significant positive correlation (P=0.001). Time to referral decreased for both male and female patients diagnosed with a head and neck cancer in the years 19882000 at the VCU Massey Cancer Center. Although some trends relating changes in DTR and increased patient age are seen, there were no clear gender differences.