Abstract
Serious delay in patients presenting with head and neck cancer is associated with
poor outcomes. We aimed to examine the influence of deprivation on professional delay
in the Mersey region from 2004 to 2006. The study sample comprised 6681 patients who
were referred between January 2004 and December 2006. The dataset was dominated by
the largest hospital (H1), which received 48% of all cases. Median referral overall
was 12 days (IQR 8–15 days), and 74% of patients were referred in 14 days or less.
Professional delay (percentage 14 days or less) was associated with hospital (from
58% H1 to 97% H5), year of referral (from 64% in 2004 to 80% in 2006), age (from 69%
under 55 years to 80% over 75 years), and deprivation (Index of Multiple Deprivation
2000 from 67% most deprived (IMD 1) to 85% least deprived (IMD 5)). Hospital location
was associated with these factors and the results imply that by far, the most important
variable in predicting professional delay was the hospital that received the referral.
Trends over time in age, and to a lesser extent, for deprivation were noted in H1,
but were largely absent across other hospitals. Some of them needed to make substantial
improvements to meet the two-week referral pathway and it would be interesting to
compare these results with current practice. This study highlights the importance
of maintaining the standards of the current policy on two-week referrals for suspected
head and neck malignancy.
Keywords
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Article info
Publication history
Published online: June 02, 2011
Accepted:
May 3,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
