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Impact of coronavirus disease 2019 on head and neck urgent suspected cancer referral pathways in rural Wales

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  31 March 2022

E Abelardo Open the ORCID record for E Abelardo [Opens in a new window] ,
R Gravelle ,
M Scannell ,
P Shastri ,
M Vandekar ,
G Davies ,
L Volpini Open the ORCID record for L Volpini [Opens in a new window]  and
V Prabhu
E Abelardo*
Affiliation:
ENT – Head and Neck Surgery Department, Glangwili General Hospital, Hywel Dda University Health Board, Carmarthen, Wales, UK Institute of Life Sciences 2, Swansea University Medical School, Wales, UK
R Gravelle
Affiliation:
ENT – Head and Neck Surgery Department, Glangwili General Hospital, Hywel Dda University Health Board, Carmarthen, Wales, UK
M Scannell
Affiliation:
ENT – Head and Neck Surgery Department, Glangwili General Hospital, Hywel Dda University Health Board, Carmarthen, Wales, UK
P Shastri
Affiliation:
ENT – Head and Neck Surgery Department, Glangwili General Hospital, Hywel Dda University Health Board, Carmarthen, Wales, UK
M Vandekar
Affiliation:
ENT – Head and Neck Surgery Department, Glangwili General Hospital, Hywel Dda University Health Board, Carmarthen, Wales, UK
G Davies
Affiliation:
Programme Management Office, Hywel Dda University Health Board, Carmarthen, Wales, UK Respiratory Innovation Wales Ltd, Swansea, Wales, UK Swansea University Medical School, Wales, UK
L Volpini
Affiliation:
ENT – Head and Neck Surgery Department, Glangwili General Hospital, Hywel Dda University Health Board, Carmarthen, Wales, UK
V Prabhu
Affiliation:
ENT – Head and Neck Surgery Department, Glangwili General Hospital, Hywel Dda University Health Board, Carmarthen, Wales, UK
*
Author for correspondence: Mr Edgardo Abelardo, ENT – Head and Neck Surgery Department, Glangwili General Hospital, Dolgwili Road, CarmarthenSA31 2AF, Wales, UK E-mail: E.Abelardo@swansea.ac.uk
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Abstract

Objective

To assess the impact of the coronavirus disease 2019 pandemic on head and neck urgent suspected cancer referral pathways in rural areas of Wales.

Method

A retrospective audit was conducted of 2234 head and neck urgent suspected cancer referrals received from January 2019 to November 2020.

Results

The referrals dropped by 35 per cent in 2020 compared to the same period in 2019. The time from general practitioner referral to the first ENT appointment improved during the pandemic (8.0 vs 10.0 days; p < 0.001). Of referrals, 92.1 per cent were seen within a 14-day period in 2020, compared with 79.6 per cent in 2019 (p < 0.001). There were no differences between 2020 and 2019 in terms of: the (confirmed cancer) conversion rate (10.6 per cent vs 9.7 per cent; p = 0.60), general practitioner referral to multidisciplinary team discussion time (35.5 vs 41.5 days; p = 0.40) or general practitioner referral to initiation of treatment time (68.0 vs 78.0 days; p = 0.16).

Conclusion

Whilst coronavirus disease 2019 reduced the number of overall head and neck urgent suspected cancer referrals, the pathways were generally unchanged, if not slightly improved, in rural Wales.

Keywords

Head And Neck CancerCOVID-19Time-To-Treatment
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 6 , June 2022 , pp. 540 - 546
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr E Abelardo takes responsibility for the integrity of the content of the paper

Presented as a poster at the British Association of Head and Neck Oncologists Annual Scientific Meeting, 14 May 2021 (online platform).

References

NHS England and NHS Improvement. In: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/urgent-next-steps-on-nhs-response-to-covid-19-letter-simon-stevens.pdf [24 February 2021]Google Scholar
Osborne, MS, Bentley, A, Farrow, A, Chan, J, Murphy, J. Impact of coronavirus disease 2019 on urgent referrals to secondary care otolaryngology: a prospective case series. J Laryngol Otol 2020;134:957–60CrossRefGoogle Scholar
Filipe, MD, van Deukeren, D, Kip, M, Doeksen, A, Pronk, A, Verheijen, PM et al. Effect of the COVID-19 pandemic on surgical breast cancer care in the Netherlands: a multicenter retrospective cohort study. Clin Breast Cancer 2020;20:454–61CrossRefGoogle ScholarPubMed
Søreide, K, Hallet, J, Matthews, JB, Schnitzbauer, AA, Line, PD, Lai, PBS et al. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Br J Surg 2020;107:1250–61CrossRefGoogle ScholarPubMed
Royal College of Surgeons of England. More than 200,000 patients waiting over a year for hospital treatment. In: https://www.rcseng.ac.uk/news-and-events/media-centre/press-releases/waiting-times-dec-2020/ [24 February 2021]Google Scholar
Nuffield Trust. Rural, remote and at risk: Why rural health services face a steep climb to recovery from Covid-19. In: https://www.nuffieldtrust.org.uk/research/rural-remote-and-at-risk [24 February 2021]Google Scholar
StatsWales. Population estimates by local health boards and age. In: https://statswales.gov.wales/Catalogue/Population-and-Migration/Population/Estimates/Local-Health-Boards/populationestimates-by-lhb-age [24 February 2021]Google Scholar
Hywel Dda Health Board Profile. In: https://gov.wales/sites/default/files/statistics-and-research/2018-12/160622-workforce-welsh-language-support-primary-care-hywel-dda-en.pdf [24 February 2021]Google Scholar
Hywel Dda University Health Board Annual Report and Accounts 2019/2020. In: https://hduhb.nhs.wales/about-us/performance-targets/performance-documents/annual-report-and-accounts-2019-20/ [26 February 2021]Google Scholar
StataCorp. Stata Statistical Software: Release 16. College Station, Texas: StataCorp, 2019Google Scholar
Cancer Waiting Times (CWT) urgent suspected cancer referrals: referral, conversion and detection rates. In: https://www.cancerdata.nhs.uk/cwt_conversion_and_detection [8 March 2021]Google Scholar
Taylor, R, Omakobia, E, Sood, S, Glore, RJ. The impact of coronavirus disease 2019 on head and neck cancer services: a UK tertiary centre study. J Laryngol Otol 2020;34:684–7CrossRefGoogle Scholar
National Disease Registration Service. In: https://www.ndrs.nhs.uk/more-cancers-are-being-diagnosed-through-urgent-suspected-cancer-referral-exploring-the-data-using-a-new-visualisation-tool/ [24 February 2021]Google Scholar
Rimmer, J, Watson, J, O'Flynn, P, Vaz, F. A head and neck ‘two-week wait’ clinic: cancer referrals or the worried well? Ann R Coll Surg Engl 2012;94:1–4CrossRefGoogle Scholar
Langton, S, Siau, D, Bankhead, C. Two-week rule in head and neck cancer 2000–14: a systematic review. Br J Oral Maxillofac Surg 2016;54:120–31CrossRefGoogle ScholarPubMed
Tikka, T, Kavanagh, K, Lowit, A, Jiafeng, P, Burns, H, Nixon, I et al. Head and neck cancer risk calculator (HaNC-RC)-V.2. Adjustments and addition of symptoms and social history factors. Clin Otolaryngol 2020;45:380–8CrossRefGoogle ScholarPubMed
Remote triaging of urgent suspected head and neck cancer referrals during Covid-19 pandemic. In: https://www.entuk.org/sites/default/files/files/ENTUK_2WW_Telephone_Triage_Letter.pdf [25 May 2021]Google Scholar
Everitt, S, Plumridge, N, Herschtal, A, Bressel, M, Ball, D, Callahan, J et al. The impact of time between staging PET/CT and definitive chemo-radiation on target volumes and survival in patients with non-small cell lung cancer. Radiother Oncol 2013;106:288–91CrossRefGoogle ScholarPubMed
Public Health Wales Rapid COVID-19 Surveillance. In: https://public.tableau.com/profile/public.health.wales.health.protection#!/vizhome/RapidCOVID-19virology-Public/Headlinesummary [19 April 2021]Google Scholar