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Impact of primary care triage using the Head and Neck Cancer Risk Calculator version 2 on tertiary head and neck services in the post-coronavirus disease 2019 period

Published online by Cambridge University Press:  22 January 2024

Jiak-Ying Tan Open the ORCID record for Jiak-Ying Tan [Opens in a new window] ,
Christopher John Callaghan ,
Alexander William Lewthwaite ,
Claudia Ching Hei Chan ,
Colette Teng Wee ,
Emily Yeg Hei To Open the ORCID record for Emily Yeg Hei To [Opens in a new window] ,
Isabel Summers ,
James William Nelson ,
Mathew Benjamin Smith  and
Lucy Qian Li
...Show all authors
Jiak-Ying Tan*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, NHS Lothian, Edinburgh, Scotland, UK
Christopher John Callaghan
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
Alexander William Lewthwaite
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
Claudia Ching Hei Chan
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
Colette Teng Wee
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
Emily Yeg Hei To
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
Isabel Summers
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
James William Nelson
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
Mathew Benjamin Smith
Affiliation:
University of Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
Lucy Qian Li
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, NHS Lothian, Edinburgh, Scotland, UK
Catriona Morton
Affiliation:
GP Referral Advisor, NHS Lothian, Edinburgh, UK
Lorna Porteous
Affiliation:
Primary Care, NHS Lothian, Edinburgh, Scotland, UK
Andrew Stewart Evans
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, NHS Lothian, Edinburgh, Scotland, UK
Iain James Nixon
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, NHS Lothian, Edinburgh, Scotland, UK
*
Corresponding author: Jiak-Ying Tan; Email: jiakyingt@doctors.org.uk
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Abstract

Objective

This study investigates the impact of primary care utilisation of a symptom-based head and neck cancer risk calculator (Head and Neck Cancer Risk Calculator version 2) in the post-coronavirus disease 2019 period on the number of primary care referrals and cancer diagnoses.

Methods

The number of referrals from April 2019 to August 2019 and from April 2020 to July 2020 (pre-calculator) was compared with the number from the period January 2021 to August 2022 (post-calculator) using the chi-square test. The patients’ characteristics, referral urgency, triage outcome, Head and Neck Cancer Risk Calculator version 2 score and cancer diagnosis were recorded.

Results

In total, 1110 referrals from the pre-calculator period were compared with 1559 from the post-calculator period. Patient characteristics were comparable for both cohorts. More patients were referred on the cancer pathway in the post-calculator cohort (pre-calculator patients 51.1 per cent vs post-calculator 64.0 per cent). The cancer diagnosis rate increased from 2.7 per cent in the pre-calculator cohort to 3.3 per cent in the post-calculator cohort. A lower rate of cancer diagnosis in the non-cancer pathway occurred in the cohort managed using the Head and Neck Cancer Risk Calculator version 2 (10 per cent vs 23 per cent, p = 0.10).

Conclusion

Head and Neck Cancer Risk Calculator version 2 demonstrated high sensitivity in cancer diagnosis. Further studies are required to improve the predictive strength of the calculator.

Keywords

head and neck cancerprimary health carereferral andconsultationtriage
Type
Main Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 6
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Jiak-Ying Tan takes responsibility for the integrity of the content of the paper

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