The impact of 2 weeks wait referral on survival of head and neck cancer patients

Abstract

Purpose This study aims to evaluate the association between 2 weeks wait referral and survival in the head and neck cancer. Methods Retrospective cohort study of consecutively discussed new head and neck cancer patients at large United Kingdom Cancer Alliance including two tertiary referral hospitals and two district general hospital. Results A total of 276 cancer patients were included for analysis. Patients referred under the 2 weeks wait had were seen and diagnosed sooner from referral (p < 0.0001 and p < 0.0001 respectively). However, this did not translate into better survival outcomes. No survival differences were seen between those patients that were managed within the proposed cancer targets and those that were not. Conclusions The 2 weeks wait head and neck cancer pathway did not offer a survival advantage. Targeting the delay in referral as well as delay in treatment to prevent late-stage cancer presentation is paramount. Fulfilment of cancer time targets do not translate into better outcomes and should not be prioritised to clinical judgement.

Head-and-neck Cancer in the Emergency Department: A Contemporary Review of Common Presentations and Management

“…[ 8 ] In HNC, around 10%–15% present via the emergency department and it translates into more advanced stage at diagnosis and worse survival outcomes. [ 9 ] Accordingly, there is a need for a better understanding of HNC presenting symptoms, so general practitioners and emergency department doctors can identify them early to improve diagnosis and prognosis. [ 10 ] This is particularly relevant when considering the increasing incidence of human papillomavirus (HPV)-related HNC that is changing the paradigm of patients with this disease.…”

Nomenclature of the symptoms of head and neck cancer: a systematic scoping review

“…The difficulty for primary care in recognising HNC exist in large part because they will see a case of HNC so rarely, HNC originates from multiple tissue types across neighbouring anatomical sites which are often outside the examination field without specialist equipment and cancers can cause overlapping symptoms. The interpretation and misinterpretation of, particularly, the symptoms and physical signs of HNC have been a source of frustration for Ear Nose and Throat (ENT) and maxillofacial surgeons (OMFS) alike ( 9 ). The comparative ease with which the Two week wait (TWW) and Urgent Suspicion of Cancer (USOC) pathway (in Scotland) can be accessed in primary care for referrals and the emphasis on early cancer recognition and detection issued from the NHS, government and charitable bodies has decidedly changed the referral practices and subsequently resources required to meet the volume of patient referrals.…”