Deprivation in relation to urgent suspicion of head and neck cancer referrals in Glasgow

Zeitler, M.; Fingland, P.; Tikka, Theofano; Douglas, Catriona; Montgomery, Jenny

doi:10.1111/coa.13077

Cited by 8 publications

(8 citation statements)

References 17 publications

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“…Additionally, a local review of head and neck cancer patients with respect to deprivation score has shown that more deprived patients present with more advanced disease. 12 This highlights the need for increased public education regarding the red flag symptoms, with the ultimate goal of early rather than late disease at presentation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Palliative intent treatment for head and neck cancer: an analysis of practice and outcomes

et al. 2019

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BackgroundThere is little consensus on how best to manage head and neck cancer with palliative intent. Predicting outcome is difficult and reported survival varies. The present study sought to delineate local practice and outcomes in patients treated with palliative intent.MethodsThe clinical records of all head and neck cancer patients treated with palliative intent presenting between 2015 and 2016 to our multidisciplinary team were reviewed.ResultsEighty-four patients (21.5 per cent) were treated with palliative intent. All had squamous cell carcinoma. Mean survival time was 151 days (standard deviation = 121.1; range, 8–536 days). Of the patients, 83.3 per cent had a palliative care referral; 74.1 per cent had a hospice referral. Patients received a variety of interventions, and there was an associated complication in 8.2 per cent. The mean number of days spent in hospital for interventions was 11.9 days (standard deviation = 12.5; range, 0–41 days).ConclusionDifferent interventions are used to manage head and neck cancer patients with palliative intent, and these may be associated with significant morbidity. Survival time is variable, often several months; thus, any treatment must take into account morbidity in conjunction with the patient's wishes.

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Section: Discussionmentioning

confidence: 99%

“…Recent work in our department has shown that almost half of males with head and neck cancer live alone. 12 There are unique barriers to discharge from hospital in head and neck cancer cases. Managing tracheostomies and feeding tubes may pose a perceived challenge to relatively inexperienced healthcare staff and family members.…”

Section: Discussionmentioning

confidence: 99%

Palliative intent treatment for head and neck cancer: an analysis of practice and outcomes

et al. 2019

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“…Referral patterns consistently show that more females are referred for cancer investigation, yet more males are diagnosed with head and neck cancer. 12 Most patients referred to clinic are in their sixth decade, with cancer occurring most frequently in the seventh decade.…”

Section: Discussionmentioning

confidence: 99%

“…Previous analysis of ‘urgent suspicion of cancer’ referrals revealed that globus is frequently referred under the dysphagia category. 12 Currently, the non-red flag symptoms most commonly associated with patient concern are globus and pain in the neck area. Globus sensation tends to be referred as dysphagia.…”

Section: Discussionmentioning

confidence: 99%

‘Urgent suspicion of cancer’ referrals to a head and neck clinic – what do patients expect?

et al. 2019

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BackgroundPublic awareness of ‘red flag’ symptoms for head and neck cancer is low. There is a lack of evidence regarding patient concerns and expectations in consultations for cancer assessment.MethodThis prospective questionnaire study examined the symptoms, concerns and expectations of 250 consecutive patients attending an ‘urgent suspicion of cancer’ clinic at a tertiary referral centre.ResultsThe patients’ most frequent responses regarding their concerns were ‘no concerns’ (n = 72, 29 per cent); ‘all symptoms’ were a cause for concern (n = 65, 26 per cent) and ‘neck lump’ was a symptom causing concern (n = 37, 17 per cent). The expectations of patients attending clinic were that they would find out what was wrong with them, followed by having no expectations at all. Overall patient knowledge of red flag symptoms was lacking and their expectations were low.ConclusionPatients with non-cancer symptoms are frequently referred with suspected cancer. Patients with red flag symptoms are not aware of their significance and they have low expectations of healthcare.

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“…It is interesting that socioeconomic status has not impacted upon the presence of laryngeal cancer in this study, a finding made in all cases of head and neck cancer urgent referrals. 13 As previously mentioned in the introduction, head and neck risk calculators are available, and are being updated. 3,4 This study does not purport to be any form of risk calculator but rather an in-depth analysis of hoarseness, the most frequent red flag symptom seen in otolaryngology clinic.…”

Section: Literature Comparisonmentioning

confidence: 99%

Patterns of urgent hoarseness referrals to ENT—When should we be suspicious of cancer?

Douglas

Middleton

Sim

et al. 2021

Clinical Otolaryngology

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Persistent hoarseness, as a symptom of laryngeal cancer, is one of the most frequent referrals made in the "urgent suspicion of cancer" (USOC) category in Scotland. This is equivalent to the "2-week wait" category in England. The Scottish Referral Guidelines (SRG) make no exclusions on age of patients with hoarseness, unlike the NICE guidelines 1 which stipulate that referrals are only received for patients 45 years or older. Hoarseness as a presentation of laryngeal cancer is important. Most head and neck cancers present in advanced stages, yet hoarseness as a presenting symptom can be a marker of early-stage disease. 2 The vast majority of patients referred with hoarseness can be safely reassured and discharge following examination and while much is currently published on the risk of having laryngeal cancer, 3,4 examining other factors in relation to laryngeal health and focusing on the lower risk benign group is an understudied area.There are around 2500 cases of laryngeal cancer diagnosed in the UK each year. 5 Laryngeal cancer overwhelmingly presents in older patients-3 quarters of all diagnoses are in patients aged over 60 years. 2 It is well documented that tobacco and alcohol are the main causative factors for larynx cancer. Compared to oropharyngeal cancer, the human papilloma virus does not appear to be a major cause. 6 Laryngeal cancer is more common in males than females (a ratio of 4.5 men to 1 woman) and is more commonly diagnosed in patients of a lower socioeconomic group. 7

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Deprivation in relation to urgent suspicion of head and neck cancer referrals in Glasgow

Cited by 8 publications

References 17 publications

Palliative intent treatment for head and neck cancer: an analysis of practice and outcomes

Palliative intent treatment for head and neck cancer: an analysis of practice and outcomes

‘Urgent suspicion of cancer’ referrals to a head and neck clinic – what do patients expect?

Patterns of urgent hoarseness referrals to ENT—When should we be suspicious of cancer?

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