A review of the Oral Cancer Referral Pathway System in the Dublin Dental University Hospital

Abstract

##Introduction: The incidence of oral and oropharyngeal cancer in Ireland is increasing with approximately 503 cases diagnosed annually. A delay in diagnosis for oral cancer leads to advancement in tumour staging which increases the risk of mortality by up to 2-fold. Early detection contributes to the reduction of morbidity and improvement of survival rates. ##Aim: This review aims to assess the sources of referral and evaluate the efficiency of DDUH’s oral cancer referral pathway system. ##Methods: A retrospective search was carried out through the hospital’s electronic dental records (EDR) of patients from 1st of January to 31st of December 2019. Patients who received a histological diagnosis of oral cancer from biopsies carried out were identified and their EDR accessed. ##Results: In 2019, there were 65 confirmed diagnoses of oral cancer in the Dublin Dental University Hospital (DDUH) of which majority (89%) of the cases were assessed within 2 weeks. A large proportion (89%) received the diagnosis within a month from the referral date. The primary cause of delay in the clinical pathway is the delay in patients presenting to primary care. Only 50% of patients with symptoms synonymous with oral cancer presented to primary care within 4 weeks. ##Conclusion: The ‘open door’ policy adopted by the DDUH is beneficial in terms of direct access, reducing waiting time and allows for early detection of oral cancer which helps reduce morbidities and improve the overall survival rates of oral cancer cases.