The 2-week rule for suspected head and neck cancer in the United Kingdom: referral patterns, diagnostic efficacy of the guidelines and compliance

A selection of abstracts of clinically relevant papers from other journals. The abstracts on this page have been chosen and edited by John R. Radford.

Abstract

Present referral guidelines for head and neck cancer should be re-fined.

Main

McKie C, Ahmad UA et al. Oral Oncol 2008; 44: 815–856

This retrospective audit carried out on patients with suspected head and neck cancer (n = 1,079) between January 2004 and December 2006, showed that over 97% were seen by a specialist within 2 weeks of referral. Only 71.5% of these patients complied with Department of Health referral guidelines for suspected head and neck cancer. In addition, these guidelines 'contributed only 21.4% (of total cancers diagnosed)' and, furthermore, did not identify early stage disease. The authors argue that if hoarseness, the criterion that comprises the largest number of referrals, 'was modified to include only smokers and ex-smokers, 47.7% of these referrals could be avoided' with, in this study, no cancers missed. Regardless as to whether or not the guidelines were met, only 10.9% of those referred were diagnosed with cancer.