One‐Stop Throat and Virtual Neck Lump Clinic Shortens Diagnostic Work‐Up for Head and Neck Cancer
Woo‐Young Yang, Zakariya Sattar, Celine Iswarya Partha Sarathi, Ali Wadood, Adrian Hall, Ayeshea Shenton, Max Sallis OsborneABSTRACT
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.
Level of Evidence
3.