Accelerating diagnosis and refining referral criteria in head and neck cancer: insights from a multidisciplinary fast-track pathway.

PURPOSE

Despite advancements, 54% of head and neck cancer patients in Europe are diagnosed at advanced stages. The fast-track head and neck cancer pathway (FTHNCP) was implemented in 2018 in our hospital to reduce diagnostic delays and improve patient outcomes. This study aimed to evaluate the effectiveness of the FTHNCP in reducing diagnostic delays and identifying factors associated with oncological diagnoses.

METHODS

A retrospective observational study analyzed 1453 patients referred via the FTHNCP between January 2018 and August 2023. Data collected included demographics, symptoms, diagnostic tests, and timelines from symptom onset to treatment initiation. Statistical analysis was performed to identify factors associated with oncological diagnoses, focusing on variables, such as age, gender, toxic habits, and clinical presentation.

RESULTS

The median age of the cohort was 61 years, with 50.64% being male. The average time from referral to specialist consultation was 11.59 days. Among the referred patients, 19.89% received an oncological diagnosis, with squamous cell carcinoma being the most frequent (11.51%). Statistical analysis identified significant associations between malignancy and male gender, older age, toxic habits, and the presence of oral ulcers.

CONCLUSIONS

The FTHNCP demonstrates potential for early diagnosis of head and neck cancer, significantly reducing waiting times for specialist evaluation. However, the high proportion of benign diagnoses or absence of pathology highlights the need to optimize referral criteria. Incorporating risk scoring systems based on epidemiological and clinical factors could enhance diagnostic specificity. A multidisciplinary approach and further studies are recommended to refine the pathway and improve diagnostic efficiency.