A novel remote assessment pathway to streamline the management of two-week-wait suspected head and neck cancer referrals: a prospective analysis of 660 patients.

Abstract

This study analyses outcomes for 660 patients managed via a novel telescopic pathway for suspected head and neck cancer referrals. Data were collected prospectively between January 2021 and December 2022, capturing all two-week-wait referrals triaged as low risk and managed via a nurse-led clinic for nasendoscopic examination and consultant-led remote assessment. In total, 660 patients were included. There were six head and neck cancers diagnosed, giving a conversion rate of 0.9 per cent. Mean (standard deviation) time to informing the patient whether they did or did not have cancer (28-day faster diagnosis standard) was 28.6 days (20.2), with no significant difference observed in patients imaged prior to review (p = 0.63). No missed cancers were detected in the follow-up period. Low-risk head and neck cancer referrals can be safely managed in a nurse-led clinic for recorded examination with asynchronous consultant-led management. Further work is required to ensure adherence to the new faster diagnosis standard.