886 Assessment of Urgent Neck Lump Referrals to a North West ENT Clinic

Abstract

Abstract Aim NHS cancer diagnostic services are under immense pressures due to high referral numbers. We assessed the volume of urgent neck lump referrals to ENT clinic at a North West hospital, determining the number of cancers and benign cases and calculating the average time to diagnosis and treatment for those with cancer. Method We retrospectively reviewed 616 urgent referrals to ENT via the 2-week wait suspected cancer pathway between October 2021 – March 2022, including only primary care referrals for neck, thyroid, or salivary gland lumps. Results Of 616 urgent referrals, 46.8% were for neck, thyroid or salivary gland lumps. Primary care accounted for 85.8% of referrals, the majority being female (71.3%). The cancer pick-up rate (thyroid/head and neck/lymphoma) was 10.1%. Benign neck pathology accounted for 57.1% of cases, and in 22.7% of cases no abnormalities were detected. Only 28% of those found to have cancer had an ultrasound scan (USS) prior to clinic. Average time to diagnosis for those with cancer was 46.5 days (58 days for thyroid cancer), and average time to treatment was 62 days (78 days for thyroid cancer). Conclusions This audit highlights the strain that cancer diagnostic services are under. In our case, approximately 31.6% of patients could have been downgraded from the cancer pathway if USS was used as a vetting tool prior to clinic. To help relieve the burden on cancer pathways and improve average time to diagnosis and treatment for those found to have cancer, we suggest patients have USS within 7 days of referral.