Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-18T17:58:58.782Z Has data issue: false hasContentIssue false
  • English
  • Français

Two-week referrals for suspected head and neck cancer: two cycles of audit, 10 years apart, in a district general hospital

Published online by Cambridge University Press:  22 July 2014

C Williams ,
R Byrne ,
D Holden ,
I Sherman  and
V R Srinivasan
C Williams
Affiliation:
ENT/Thyroid Surgery Department, Arrowe Park Hospital, Upton, Wirral, UK
R Byrne
Affiliation:
ENT/Thyroid Surgery Department, Arrowe Park Hospital, Upton, Wirral, UK
D Holden
Affiliation:
ENT/Thyroid Surgery Department, Arrowe Park Hospital, Upton, Wirral, UK
I Sherman
Affiliation:
ENT/Thyroid Surgery Department, Arrowe Park Hospital, Upton, Wirral, UK
V R Srinivasan*
Affiliation:
ENT/Thyroid Surgery Department, Arrowe Park Hospital, Upton, Wirral, UK
*
Address for correspondence: Mr V Srinivasan, ENT Department, Arrowe Park Hospital, Arrowe Park Road, Wirral CH49 5PE, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To analyse trends in two-week rule referrals for head and neck cancer over 10 years.

Method:

Data from two-week referrals received by the Wirral University Hospital NHS Trust between 1 January and 30 June 2012 were compared with similar data from 2002.

Results:

A total of 357 referrals were received during the 6-month audit period, compared with 149 during the whole of 2002. Cancer pick-up rates were 9 per cent and 5 per cent in the first and second cycles, respectively.

Conclusion:

The annual number of two-week referrals made to our department increased by over 450 per cent in 10 years, but the resulting cancer pick-up rate fell by nearly 50 per cent. Whilst cancer patients need to be seen quickly, the current system is inefficient in parts. Modifications to the treatment pathway should be considered to improve patient care quality and reduce pressure on ENT departments.

Keywords

Head and Neck NeoplasmsReferral and ConsultationGuideline Adherence
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 8 , August 2014 , pp. 720 - 724
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1NHS Information Centre. National head and neck cancer audit. 6th annual report. Leeds: NHS Information Centre for Health and Social Care, 2011Google Scholar
2Centre for Clinical Practice at NICE. Guidance on cancer services: improving outcomes in head and neck cancer. The manual. London: National Institute for Clinical Excellence, 2004Google Scholar
3Scottish Intercollegiate Guidelines Network. Diagnosis and management of head and neck cancer. Edinburgh: Scottish Intercollegiate Guidelines Network, 2006Google Scholar
4Marur, S, Forastiere, AA. Head and neck cancer: changing epidemiology, diagnosis and treatment. Mayo Clin Proc 2008;83:489–501Google Scholar
5Parkin, DM, Pisani, P, Ferlay, J. Estimates of the worldwide incidence of eighteen major cancers in 1985. Int J Cancer 1993;54:594–606Google Scholar
6Sanderson, RJ, Montague, ML. Surgical management of head and neck malignancy. Surgeon 2004;2:7–14Google Scholar
7La Vecchia, C, Tavani, A, Franceschi, S, Levi, F, Corrao, G, Negri, E. Epidemiology and prevention of oral cancer. Oral Oncol 1997;33:302–12Google Scholar
8D'Souza, G, Kreimer, AR, Viscidi, R, Pawlita, M, Fakhry, C, Koch, WM et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 2007;356:1944–56CrossRefGoogle ScholarPubMed
9Berrino, F, Sant, M, Verdecchia, A, Capocaccia, R. Survival of cancer patients in Europe—the EUROCARE study. IARC Sci Publ 1995;132:1–475Google Scholar
10Coebergh, JWW, Sant, M, Verdecchia, A, Capocaccia, R, Hakulinen, T, Estève, J. Survival of adult cancer patients in Europe diagnosed from 1978–1989: The EUROCARE II Study. Eur J Cancer 1998;34:2137–78Google Scholar
11Berrino, F, Capocaccia, R, Estève, J, Gatta, G, Hakulinen, T, Micheli, M et al. Survival of cancer patients in Europe: the EUROCARE-2 study. IARC Sci Publ 1999;151:1–572Google Scholar
12Department of Health. The New NHS: Modern, Dependable. London: HMSO, 1997Google Scholar
13Department of Health. The NHS Cancer Plan: A Plan for Investment, a Plan for Reform. London: HMSO, 2000Google Scholar
14Perros, P, ed. Guidelines for the management of thyroid cancer, 2nd edn. In: Report of the Thyroid Cancer Guidelines Update Group. London: British Thyroid Association, Royal College of Physicians, 2007Google ScholarPubMed
15Pacifico, MD, Pearl, RA, Grover, R. The UK Government two-week rule and its impact on melanoma prognosis: an evidence-based study. Ann R Coll Surg Engl 2007;89:609–615Google Scholar
16Potter, S, Govindarajulu, S, Shere, M, Braddon, F, Curran, G, Greenwood, R et al. Referral patterns, cancer diagnoses, and waiting times after introduction of two week wait rule for breast cancer: prospective cohort study. BMJ 2007;335:288CrossRefGoogle ScholarPubMed
17Thorne, K, Hutchings, HA, Elwyn, G. The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: a systematic literature review. BMC Health Serv Res 2006;6:43Google Scholar
18Hobson, JC, Malla, JV, Sinha, J, Kay, NJ, Ramamurthy, L. Outcomes for patients referred urgently with suspected head and neck cancer. J Laryngol Otol 2008;122:1241–44Google Scholar
19Lyons, M, Philpott, J, Hore, I, Watters, G. Audit of referrals for head and neck cancer – the effect of the 2-week, fast track referral system. Clin Otolaryngol Allied Sci 2004;29:143–5Google Scholar