Rapid Access Neck Lump Clinic-A First of Its Kind in Australia; a Prospective Analysis Over a Five Year Period

Rapid Access Neck Lump clinics are specialised clinics that focus on the evaluation, diagnosis and management of head and neck lumps in a timely manner. Internationally, these dedicated clinics are being utilised to improve outcomes of head and neck cancer patients. To date, there are only a few such clinics in the Australian public health system. The objective of this study was to demonstrate the benefits of a rapid access neck lump clinic, aiming to reduce waiting times for diagnosis and treatment commencement.

A multidisciplinary consultant led rapid access neck lump clinic was established including a head and neck surgeon, radiologist, and pathologist. This allowed comprehensive evaluation of the patient with a neck lump in a single visit. Data were collected prospectively for all attendances at this clinic since its inception, over a five-year period from February 2018 to February 2023. The primary outcome was clinic efficiency including referral to assessment interval and time to diagnosis. Secondary outcomes included malignancy rate, diagnostic accuracy of fine needle aspiration cytology, and time to treatment initiation.

The review included 437 consecutive patients seen in the clinic. The mean time from referral to first specialist assessment was 16.1 (+/-9.54 days). Ultrasound guided FNA was performed in 61% of patients and yielded a malignancy rate of 38.6%. The median number of days between specialist assessment and discussion at head and neck MDT was 5 days. The mean time between clinic review and treatment commencement was 39.3 days.

This is the largest and first dataset of a rapid access neck lump clinic in Australia. The implementation of this clinic has reduced delays to assessment, diagnosis and consequentially treatment planning and treatment for patients with newly diagnosed head and neck cancer.