Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-20T03:25:24.681Z Has data issue: false hasContentIssue false
  • English
  • Français

Lymphoma presenting as neck lumps: causes of waiting time target breaches and potential solutions

Published online by Cambridge University Press:  04 November 2013

H Raja ,
L Pabla ,
H Wheatley  and
M R B Farr
H Raja*
Affiliation:
Department of ENT, University Hospital North Staffordshire, Stoke-on-Trent, UK
L Pabla
Affiliation:
Department of ENT, Royal Wolverhampton Hospital, Coventry, UK
H Wheatley
Affiliation:
Department of ENT, Gloucestershire Hospitals, Coventry, UK
M R B Farr
Affiliation:
Department of ENT, Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
*
Address for correspondence: Mr H Raja, 31 Wheatsheaf Rd, Edgbaston, Birmingham B16 ORZ, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

This study aimed to assess the speed of referral, diagnosis and treatment of patients with lymphoma presenting with a neck lump, and to identify where delays are occurring that prevent UK national targets from being met.

Method:

The study entailed a retrospective survey of patients presenting with a neck lump secondary to lymphoma between 2006 and 2008 in Gloucestershire, UK.

Results:

Forty-seven of 54 patients (87 per cent) were seen within 2 weeks of referral. However, the 62-day rule, which covers the time from referral to the initiation of treatment, was met in only 32 of the 54 cases (59 per cent). There were no breaches of the 31-day target, which concerned the time from decision to treat to the initiation of treatment. Subsequent target breaches were due to longer waiting times for radiological and pathological investigations.

Conclusion:

Radiological examinations should be ordered at the first consultation and biopsies performed as soon as possible. Establishing one-stop, rapid access clinics should improve the achievement of a maximum 62-day wait for patients with lymphoma presenting with neck lumps.

Keywords

NeckLymphadenopathyLymphomaNeoplasmsDelayed Diagnosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 11 , November 2013 , pp. 1111 - 1115
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Department of Health. NHS Cancer Plan: A Plan for Investment. A Plan for Reform. London: Department of Health, 2000Google Scholar
2Brenner, H, Francisci, S, de Angelis, R, Marcos-Gragera, R, Verdecchia, A, Gatta, G et al. Long-term survival expectations of cancer patients in Europe in 2000–2002. Eur J Cancer 2009;45:1028–41CrossRefGoogle ScholarPubMed
3Beral, V, Peto, R. UK cancer survival statistics. BMJ 2010;341:309–10CrossRefGoogle ScholarPubMed
4Coleman, MP, Rachet, B, Woods, L, Berrino, F, Butler, J, Capocaccia, R et al. Rebuttal to editorial saying cancer survival statistics are misleading. BMJ 2011;343:57CrossRefGoogle ScholarPubMed
5Department of Health. Cancer Waiting Targets: A Guide (Version 5). London: Department of Health, 2005Google Scholar
6National Institute for Health and Clinical Excellence. Referral Guidelines for Suspected Cancer. London: National Institute for Health and Clinical Excellence, 2005Google Scholar
7Williams, M, Drinkwater, K, Jones, A, O'Sullivan, B, Tait, D. Waiting times for systemic cancer therapy in the United Kingdom in 2006. Br J Cancer 2008;99:695–703CrossRefGoogle ScholarPubMed
8Dawson, D, Jacobs, R, Martin, S, Smith, P. Is patient choice an effective mechanism to reduce waiting times? Appl Health Econ Health Policy 2004;3:195–203CrossRefGoogle ScholarPubMed
9Savage, S, Wotherspoon, H, Fitzsimons, E, MacKenzie, K. Cervical lymphadenopathy resulting in a diagnosis of lymphoma. Scott Med J 2008;53:13–6CrossRefGoogle Scholar
10National Institute for Health and Clinical Excellence. Improving Outcomes in Head and Neck Cancer. London: National Institute for Health and Clinical Excellence, 2004Google Scholar
11Murray, A, Stewart, C, McGarry, G, MacKenzie, K. Patients with neck lumps: can they be managed in a ‘one-stop’ clinic setting? Clin Otolaryngol Allied Sci 2000;25:471–5CrossRefGoogle Scholar
12Cozens, N. A systematic review that evaluates one-stop neck lump clinics. Clin Otolaryngol 2009;34:6–11CrossRefGoogle ScholarPubMed