title: Lymphoma presenting as neck lumps: causes of waiting time target breaches and potential solutions.
abstract: OBJECTIVE
  This study aimed to assess the speed of referral, diagnosis and treatment of patients with lymphoma presenting with a neck lump, and to identify where delays are occurring that prevent UK national targets from being met.
  
  
  METHODS
  The study entailed a retrospective survey of patients presenting with a neck lump secondary to lymphoma between 2006 and 2008 in Gloucestershire, UK.
  
  
  RESULTS
  Forty-seven of 54 patients (87 per cent) were seen within 2 weeks of referral. However, the 62-day rule, which covers the time from referral to the initiation of treatment, was met in only 32 of the 54 cases (59 per cent). There were no breaches of the 31-day target, which concerned the time from decision to treat to the initiation of treatment. Subsequent target breaches were due to longer waiting times for radiological and pathological investigations.
  
  
  CONCLUSIONS
  Radiological examinations should be ordered at the first consultation and biopsies performed as soon as possible. Establishing one-stop, rapid access clinics should improve the achievement of a maximum 62-day wait for patients with lymphoma presenting with neck lumps.
authors.affiliation: Department of ENT, University Hospital North Staffordshire, Stoke-on-Trent, UK.
authors.forename: H
authors.initials: H
authors.lastname: Raja
authors.forename: L
authors.initials: L
authors.lastname: Pabla
authors.forename: H
authors.initials: H
authors.lastname: Wheatley
authors.forename: M R B
authors.initials: MR
authors.lastname: Farr
mesh_terms: D044963:Biopsy, Fine-Needle / Q000706:statistics & numerical data; D055088:Early Detection of Cancer; D004739:England; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D061665:Time-to-Treatment; D014850:Waiting Lists