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Primary care triaging of head and neck cancer referrals using the head and neck cancer risk calculator version 2: impact on a tertiary head and neck service

Published online by Cambridge University Press:  23 August 2022

L Li Open the ORCID record for L Li [Opens in a new window] ,
T Tikka ,
C Morton ,
C Chan ,
L Hayois ,
M Henderson ,
C Hastie ,
L Lee ,
L Porteus  and
I Nixon
L Li*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, NHS Lothian, Edinburgh, UK Department of Otorhinolaryngology – Head and Neck Surgery, NHS Greater Glasgow and Clyde, Queen Elizabeth University Hospital, Glasgow, UK
T Tikka
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, NHS Greater Glasgow and Clyde, Queen Elizabeth University Hospital, Glasgow, UK
C Morton
Affiliation:
General Practitioner Referral Advisor Team, NHS Lothian, Edinburgh, UK
C Chan
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, UK
L Hayois
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, UK
M Henderson
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, UK
C Hastie
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, UK
L Lee
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, UK
L Porteus
Affiliation:
Cancer and Palliative Care, NHS Lothian, Edinburgh, Scotland, UK
I Nixon
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, NHS Lothian, Edinburgh, UK
*
Author for correspondence: Dr L Li, Department of Otorhinolaryngology – Head and Neck Surgery, NHS Lothian, Lauriston Building, 41 Lauriston Place, Edinburgh, EH3 9HB, UK E-mail: lucyli@doctors.org.uk
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Abstract

Objective

This study aimed to investigate the use of the head and neck cancer risk calculator version 2 in a primary care setting and to evaluate the impact of the risk calculator on the number of referrals stratified by urgency and cancer yield.

Method

Referrals between April 2019 and August 2019, April 2020 and July 2020 (pre-risk calculator) and August 2020 and July 2021 (post-risk calculator) were analysed. Referral urgency, head and neck cancer risk calculator version 2 score, cancer diagnosis, cancer type and further investigations were recorded.

Results

The 2023 patient encounters were analysed; there were 1110 (55 per cent) referrals before head and neck cancer risk calculator version 2 use and 913 (45 per cent) after head and neck cancer risk calculator version 2 use. A higher proportion of older (p < 0.001) and male (p < 0.013) patients were seen post-head and neck cancer risk calculator version 2 use. All cancer cases were seen on the urgent suspicion of cancer pathway post-head and neck cancer risk calculator version 2 use; however, a higher proportion of patients were seen as urgent suspicion of cancer (51.1 vs 83.5 per cent; p < 0.001). Overall, the cancer diagnosis rate increased from 2.7 to 4.1 per cent.

Conclusion

The head and neck cancer risk calculator version 2 had high sensitivity in cancer diagnosis. More studies are required to optimise the predicted versus actual cancer probability gap.

Keywords

Head And Neck NeoplasmCovid-19TriagePrimary CareReferral And Consultation
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 7 , July 2023 , pp. 763 - 768
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr L Li takes responsibility for the integrity of the content of the paper

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