One-Stop Throat and Virtual Neck Lump Clinic Shortens Diagnostic Work-Up for Head and Neck Cancer.

BACKGROUND: Diagnostic work-up for head and neck cancer requires is a complex process that can cause delay and lead to poorer outcomes. Utilizing multilayer pre-clinic risk-stratification, direct-to-test ultrasonography, parallel investigations, and local anesthetic (LA) throat biopsy can expedite treatment decisions. METHODS: All suspected head and neck cancer referrals before (n = 802) and after (n = 1417) implementing a one-stop throat/virtual neck lump clinic were analyzed for changes in time from referral to cancer treatment decision. RESULTS: Mean referral-to-decision time improved from 52.4 to 34.8 days (p < 0.001). Time to diagnostic ultrasonography improved (mean 23 to 11 days from referral). General anesthetic throat biopsies decreased by 35%. Sixty-eight percent of patients with throat lesions underwent LA biopsies on the same day. Fourteen percent of patients were safely downgraded for slower reviews with no missed cancer. CONCLUSION: A multilayer risk-stratified one-stop throat/virtual neck lump clinic expedites treatment decisions for head and neck cancer and improves resource utilization.