Coronavirus disease 2019 pandemic telephone two-week-wait referrals in head and neck cancer – how safe were they?

Abstract

Objective During the coronavirus disease 2019 pandemic, ENT-UK recommended a move from face-to-face clinics to telephone appointments. This study reviewed the safety of telephone clinics for urgent two-week-wait cancer referrals. Methods Patients consulted in telephone clinics between April and November 2020 were identified from an electronic database. Study patients included those diagnosed with malignant disease at six months. The Head and Neck Cancer Risk Calculator version 2 score, outcome of the initial clinic and final diagnoses were reviewed. Results A total of 1062 patients were triaged in clinic; 9.2 per cent (n = 98) were diagnosed with cancer at 6 months. Of these 98 patients, 69 received an urgent face-to-face appointment, 26 underwent urgent scans and 3 had a delayed telephone review. Twenty patients (20.4 per cent) diagnosed with cancer had a low-risk Head and Neck Cancer Risk Calculator score. Conclusion The late diagnosis rate of 0.28 per cent suggests a small proportion of cancer could have been missed. Telephone clinics, whilst a pragmatic means to maintain patient flow during the pandemic, could result in late diagnoses.

Nomenclature of the symptoms of head and neck cancer: a systematic scoping review

“…Remote triage using HaNC-RC was not a perfect tool even in the hands of senior specialists ( 68 ) and when used by GPs increased rather than decreased the volumes referred ( 69 ). EVEREST-HN aims to further explore these relationships and potentially integrate digital images and voice recordings to develop a system which stratifies patients in a way that benefits the NHS, the patients and cancer outcomes better than the current system.…”