Outcomes for patients referred urgently with suspected head and neck cancer

Abstract

In a group of patients with symptoms suggestive of head and neck malignancy, only 12 per cent were ultimately diagnosed with cancer. Of all the patients within the trust diagnosed with head and neck cancer, 44 per cent had come from outside the urgent referral pathway.

Do GP referral guidelines really work? Audit of an electronic urgent referral system for suspected head and neck cancer

“…This study also audited all head and neck cancer diagnoses made over the same period showing that 71% of these patients were not referred via the fast-track system. Similar studies by Williams et al [9] and Hobson et al [10] showed a cancer diagnosis in 11 and 12% respectively, of patients referred via a fast-track system over an annual period. However, similar to our study, of the 12% of cancer diagnoses made by Hobson et al, only 5% were primary head and neck cancer, the remainder being lymphoma and a variety of other malignancies.…”

Efficacy of the Two-Week Wait Referral System for Head and Neck Cancer: A Systematic Review

“…7,9,10 Three studies 5,6,8 did not report the data regarding the compliance of the referrals to the NICE guidelines and were therefore not included in the analysis.The positive predictive values of each of the referral criteria were only outlined in the paper by McKie et al 10 and so collective data were not available for meta-analysis.…”

“…5 Hobson et al demonstrated that referrals marked as urgent, which were proofread by a consultant, had a mean waiting time of 15.5 days. 9 Although there is no evidence to suggest that these delays are secondary to the greater workload generated by fast-track referrals, the increased workload to meet 2ww targets must be considered. In the setting of breast cancer, a much more common entity where the numbers of referrals are higher, there is clear evidence that the 2ww rule has led to increased waiting times for routine appointments.…”

A web‐based prediction score for head and neck cancer referrals

“…Most importantly, these studies have shown that only 5.6%‐14.6% of 2‐week referrals were diagnosed with a head and neck cancer and that majority of the cancer diagnoses were in fact via other referral routes …”