Hatoum Adam, Kumta Radhika, Boztepe Selda, Salem Amr, Virk Jagdeep
ENT Department, Whipps Cross Hospital, Barts Health NHS Trust, London, UK.
Indian J Otolaryngol Head Neck Surg. 2024 Apr;76(2):1791-1795. doi: 10.1007/s12070-023-04412-x. Epub 2023 Dec 4.
As the incidence of head and neck cancer continues to rise, the volume of referrals to our urgent suspected cancer clinics continues to rise with it. Cancer referral and review time targets are not being met within the UK, and our centre has experienced an increase in volume of referrals which cannot be met by available clinic slots. We proposed a pathway to the North East London Cancer Alliance to safely triage these patients using the Head and Neck Cancer Risk Calculator version 2 (HaNC-RCv2).
All 2-week-wait referrals to our unit in June 2023 were initially triaged in a telephone consultation by a specialty registrar working in the department. A brief history would be taken, and a risk score calculated. Those scoring < 5% were moved to routine or less urgent follow up.
120 patients were referred to our department. We were able to safely triage 48.7% patients off the urgent suspected cancer pathway and to routine follow up. A total of 3 patients were found to have a head and neck malignancy and all were treated within the 62 day window.
As trusts work to cut the waiting times following the COVID-19 pandemic, there is an evident need for more efficient practices. The use of validated, safe triaging methods such as this can play a central role.
随着头颈癌发病率持续上升，转诊至我们紧急疑似癌症诊所的患者数量也随之不断增加。在英国，癌症转诊及复查时间目标未能实现，而我们中心的转诊量增加，现有门诊时段已无法满足需求。我们向北伦敦癌症联盟提出了一条途径，即使用头颈癌风险计算器第2版（HaNC-RCv2）对这些患者进行安全分流。
2023年6月所有转诊至我们科室的两周等待期患者，最初由该科室的专科住院医师通过电话咨询进行分流。采集简要病史并计算风险评分。评分低于5%的患者被转至常规或不太紧急的随访流程。
120名患者被转诊至我们科室。我们能够安全地将48.7%的患者从紧急疑似癌症流程中分流出来并进行常规随访。共发现3例患者患有头颈恶性肿瘤，所有患者均在62天窗口期内接受了治疗。
在各信托机构努力缩短新冠疫情后的等待时间之际，显然需要更高效的做法。使用这样经过验证的安全分流方法可发挥核心作用。
