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One of the main impediments in achieving UK Government cancer diagnosis and treatment targets is lack of diagnostic capacity. An increase in head and neck cancers by 50% in the last five years has put on additional strain. In this publication, the authors illustrate a method which has helped to speed up diagnosis and treatment of cancer patients, and proved superior to ‘one-stop’ neck lump clinics run at many centres. This new method identified patients with a suspicious neck lump through vetting by head and neck cancer specialists, and used consultant radiologist-led ultrasound slots which facilitated immediate ultrasound scanning and FNA or core biopsy. By this method, a diagnosis was made at the patient’s first consultation. The time from referral to ultrasound procedure averaged only eight days. This allowed 94% of patients to be seen within the two-week referral target time. The mean time from referral to diagnosis for suspected patients was only 9.7 days. Forty-five out of 99 patients were discharged after the first appointment, 10 scheduled for surgery, 12 diagnosed with cancer and six referred onwards to another specialty. This saved about 92 additional appointments for these 99 patients. The study shows that pre-clinic ultrasound scanning with FNA and core biopsy, where appropriate, far supersedes the efficiency of traditional ‘one-stop’ neck lump clinic. This also appears to be cost-effective and meets the stresses of resources and workforce, as well as being in safe hands.

Rethinking the ‘one-stop’ neck lump clinic: a novel pathway beyond coronavirus disease 2019.
Hariri A, Jawad S, Otero S, et al.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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