Rethinking the 'one-stop' neck lump clinic: a novel pathway beyond coronavirus disease 2019

Area of Science:

• Otolaryngology
• Diagnostic Imaging
• Oncology

Background:

• UK guidelines recommend a 'one-stop' approach for neck lump cancer referrals.
• The COVID-19 pandemic necessitated adaptations to healthcare pathways, including those for cancer diagnostics.

Purpose of the Study:

• To pilot a novel pre-clinic ultrasound pathway for neck lump assessment.
• To evaluate the outcomes, strengths, and limitations of this pathway, particularly during the COVID-19 pandemic.

Main Methods:

• Patients with two-week-wait neck lump referrals underwent pre-clinic ultrasound scans before their clinic appointments.
• Demographic, patient journey, and outcome data were collected and analyzed.

Main Results:

• Ninety-nine patients received ultrasound assessment, with diagnosis or further management occurring within an average of 14.1 days post-referral.
• At the first clinic appointment, 45 patients were discharged, 12 diagnosed with cancer, and 19 excluded cancer.
• Four ultrasounds were retrospectively identified as unnecessary.

Conclusions:

• Pre-clinic ultrasound scanning presents a viable alternative to the traditional 'one-stop' neck lump assessment.
• This pathway resulted in fewer clinic visits, accelerated diagnosis, and minimized face-to-face contact and aerosol-generating procedures.