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One-Stop Throat and Virtual Neck Lump Clinic Shortens Diagnostic Work-Up for Head and Neck Cancer
Woo-Young Yang1,2, Zakariya Sattar1, Celine Iswarya Partha Sarathi2
1ENT Department, New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, West Midlands, UK.
Background:
Diagnostic work-up for head and neck cancer requires is a complex process that can cause delay and lead to poorer outcomes. Utilizing multilayer pre-clinic risk-stratification, direct-to-test ultrasonography, parallel investigations, and local anesthetic (LA) throat biopsy can expedite treatment decisions.
Methods:
All suspected head and neck cancer referrals before (n = 802) and after (n = 1417) implementing a one-stop throat/virtual neck lump clinic were analyzed for changes in time from referral to cancer treatment decision.
Results:
Mean referral-to-decision time improved from 52.4 to 34.8 days (p < 0.001). Time to diagnostic ultrasonography improved (mean 23 to 11 days from referral). General anesthetic throat biopsies decreased by 35%. Sixty-eight percent of patients with throat lesions underwent LA biopsies on the same day. Fourteen percent of patients were safely downgraded for slower reviews with no missed cancer.
Conclusion:
A multilayer risk-stratified one-stop throat/virtual neck lump clinic expedites treatment decisions for head and neck cancer and improves resource utilization.
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