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. 2023 Dec;280(12):5557-5564.
doi: 10.1007/s00405-023-08152-0. Epub 2023 Aug 1.

The impact of 2 weeks wait referral on survival of head and neck cancer patients

Aleix Rovira  1 , Beth Russell  2 , Priyanka Trivedi  3 , Onaiho Ojo  3 , Richard Oakley  4 , Edie Byrne  4 , Avisha Daryanani  4 , Mieke Van Hemelrijck  3   5 , Ricard Simo  4
Affiliations

The impact of 2 weeks wait referral on survival of head and neck cancer patients

Aleix Rovira et al. Eur Arch Otorhinolaryngol. 2023 Dec.

Abstract

Purpose: This study aims to evaluate the association between 2 weeks wait referral and survival in the head and neck cancer.

Methods: Retrospective cohort study of consecutively discussed new head and neck cancer patients at large United Kingdom Cancer Alliance including two tertiary referral hospitals and two district general hospital.

Results: A total of 276 cancer patients were included for analysis. Patients referred under the 2 weeks wait had were seen and diagnosed sooner from referral (p < 0.0001 and p < 0.0001 respectively). However, this did not translate into better survival outcomes. No survival differences were seen between those patients that were managed within the proposed cancer targets and those that were not.

Conclusions: The 2 weeks wait head and neck cancer pathway did not offer a survival advantage. Targeting the delay in referral as well as delay in treatment to prevent late-stage cancer presentation is paramount. Fulfilment of cancer time targets do not translate into better outcomes and should not be prioritised to clinical judgement.

Keywords: Cancer screening; Diagnosis; Early diagnosis of cancer; Head and neck cancer; Hospital referrals; Survival.

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Conflict of interest statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
A Overall survival for patients under the 2WW HN referral pathway vs other referral pathways. B Recurrence free survival for patients under the 2WW HN referral pathway vs other referral pathways. (HN: Head and neck; 2WW: 2 weeks wait)
Fig. 2
Fig. 2
A Overall survival for patients under the 2WW HN referral pathway seen within 14 days from referral vs after 14 days from referral. B for patients under the 2WW HN referral pathway seen within 14 days from referral vs after 14 days from referral. C Overall survival for patients under the 2WW HN referral pathway diagnosed within 31 days from referral vs after 31 days from referral. D Overall survival for patients under the 2WW HN referral pathway diagnosed within 31 days from referral vs after 31 days from referral (HN: Head and neck; 2WW: 2 weeks wait)
Fig. 3
Fig. 3
A Overall survival for patients under the 2WW HN referral pathway vs A&E vs other referral pathways. B Recurrence free survival for patients under the 2WW HN referral pathway vs A&E vs other referral pathways. (HN: Head and neck; 2WW: 2 weeks wait; A&E: accident and emergency department)
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