title: Clinical outcome of head and neck cancer patients: a comparison between ENT patients referred via the 2 weeks wait pathway and alternative routes in the UK health system.
abstract: 2 weeks wait (2ww) referral was intended to improve cancer outcomes in the UK. However, a previous study found that 2ww failed to detect early stage head and neck cancer. There is no current study to examine the survival outcome of head and neck cancer patients diagnosed on 2ww and non-2ww pathways. The aim of this study is to compare the outcome of cancer patients diagnosed on these pathways. We performed a retrospective review of head and neck cancer patients diagnosed between 2009 and 2013 in the ENT Department at Mid-Yorkshire NHS Hospitals Trust. Gender, age, disease staging, treatment modalities, route of referrals along with survival data were documented. Survival analysis was performed for 2ww and non-2ww cancer patients. There were 4123 patients referred on 2ww during the study period. 147 patients were diagnosed with cancers on 2ww and 89 patients were diagnosed on non-2ww. There were no statistical differences in clinical staging (p = 0.416) and overall survival (p = 0.376) between 2ww and non-2ww patients. This study failed to demonstrate a better overall survival in head and neck cancer patients diagnosed on 2ww pathway within the ENT cohort. Current referral system needs to be refined to improve the survival outcome in head and neck cancer patients.
authors.affiliation: Department of ENT, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK. b.y.winson.wong@gmail.com.
authors.forename: B Y Winson
authors.identifier: http://orcid.org/0000-0002-6737-6278
authors.initials: BYW
authors.lastname: Wong
authors.affiliation: Department of ENT, Pinderfields General Hospital, Aberford Road, Wakefield, West Yorkshire, WF1 4DG, UK.
authors.forename: S
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Department of ENT, Pinderfields General Hospital, Aberford Road, Wakefield, West Yorkshire, WF1 4DG, UK.
authors.forename: H E
authors.initials: HE
authors.lastname: Cruickshank
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology; D012017:Referral and Consultation; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult
keywords: Diagnosis; Head and neck cancer; Referral guidelines; Screening; Survival; Suspected cancer