Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-30T19:55:10.706Z Has data issue: false hasContentIssue false
  • English
  • Français

The value of chest X-ray in the Scottish Referral Guidelines for suspected head and neck cancer in 2144 patients

Published online by Cambridge University Press:  30 April 2018

P Fingland ,
V Carswell ,
T Tikka ,
C M Douglas  and
J Montgomery
P Fingland
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
V Carswell
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
T Tikka
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
C M Douglas*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
J Montgomery
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
*
Address for correspondence: Ms Catriona Douglas, Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

In Scotland, patients with suspected head and neck cancer are referred on the basis of the Scottish Referral Guidelines for Suspected Cancer, rather than the National Institute for Health and Care Excellence guidelines. A chest X-ray should be requested by the general practitioner at the same time as referral for persistent hoarseness. The evidence for this is level 4.

Methods:

This audit identified adherence to this recommendation and X-ray results. All ‘urgent suspicion of cancer’ referrals to the ENT department in the National Health Service Greater Glasgow and Clyde for 2015–2016 were audited.

Results:

Persistent hoarseness for more than 3 weeks instigated referral in 318 patients (15.7 per cent). Chest X-ray was performed in 120 patients (38 per cent), which showed: no abnormality in 116 (96.7 per cent), features of infection in 2 (1.7 per cent) and something else in 2 patients (1.7 per cent). No chest X-ray altered the management of a patient.

Conclusion:

Performance of chest X-ray does not alter management and its removal from the Scottish Referral Guidelines for Suspected Cancer is recommended.

Keywords

NeoplasmsHead And NeckPractice GuidelineMass Chest X-Ray
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 5 , May 2018 , pp. 434 - 438
Copyright
Copyright © JLO (1984) Limited 2018 

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.)

Footnotes

Presented at the Royal College of Surgeons of Edinburgh Student Research Meeting, 9 December 2016, Edinburgh, Scotland, UK.

References

1Healthcare Improvement Scotland. Scottish Referral Guidelines for Suspected Cancer, May 2014. In: http://www.shb.scot.nhs.uk/board/foi/2015/09/2015-319a.pdf [27 December 2017].Google Scholar
2Tikka, T, Pracy, P, Paleri, V. Refining the head and neck cancer referral guidelines: a two centre analysis of 4715 referrals. Br J Oral Maxillofac Surg 2016;54:141–50.Google Scholar
3McKie, C, Ahmad, UA, Fellows, S, Meikle, D, Stafford, FW, Thomson, PJ et al. The 2-week rule for suspected head and neck cancer in the United Kingdom: referral patterns, diagnostic efficacy of the guidelines and compliance. Oral Oncol 2008;44:851–6.CrossRefGoogle ScholarPubMed
4Smith, C. Urgent suspected cancer referrals from general practice. Br J Gen Pract 2012;62:14.CrossRefGoogle ScholarPubMed
5Baughan, P, Keatings, J, O'Neill, B. Urgent suspected cancer referrals from general practice: audit of compliance with guidelines and referral outcomes. Br J Gen Pract 2011;61:e700–6.Google Scholar
6Prichard, LS, Whitehead, J, Moorthy, R, Pracy, P. The 2-week wait head & neck cancer referrals: is this system working? The Otorhinolaryngologist 2013;6:182–6.Google Scholar
7Hobson, JC, Malla, JV, Sinha, J, Kay, NJ, Ramamurthy, L. Outcomes for patients referred urgently with suspected head and neck cancer. J Laryngol Otol 2008;122:1241–4.Google Scholar
8Duvvi, SK, Thomas, L, Vijayanand, S, Reddy, KT. Two-week rule for suspected head and neck cancer. A study of compliance and effectiveness. J Eval Clin Pract 2006;12:591–4.Google Scholar
9Lyons, 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;29:143–5.Google Scholar
10Speets, AM, van der Graaf, Y, Hoes, AW, Kalmijn, S, Sachs, AP, Rutten, MJ et al. Chest radiography in general practice: indications, diagnostic yield and consequences for patient management. Br J Gen Pract 2006;56:574–8.Google Scholar
11Langton, S, Siau, D, Bankhead, C. Two-week rule in head and neck cancer 2000-14: a systematic review. Br J Oral Maxillofac Surg 2016;54:120–31.Google Scholar
12Hamilton, W, Sharp, D. Diagnosis of colorectal cancer in primary care: the evidence base for guidelines. Fam Pract 2004;21:99–106.Google Scholar
13Luryi, AL, Yarbrough, WG, Niccolai, LM, Roser, S, Reed, SG, Nathan, CA et al. Public awareness of head and neck cancers: a cross-sectional survey. JAMA Otolaryngol Head Neck Surg 2014;140:639–46.Google Scholar
14Nicholson, BD, Mant, D, Bankhead, C. Can safety-netting improve cancer detection in patients with vague symptoms? BMJ 2016;355:i5515.Google Scholar