{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T12:26:39Z","timestamp":1783340799682,"version":"3.54.6"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T00:00:00Z","timestamp":1564704000000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S002221511900149X_sec_a1\"><jats:title>Objectives<\/jats:title><jats:p>The National Institute for Health and Care Excellence referral guidelines prompting urgent two-week referrals were updated in 2015. Additional symptoms with a lower threshold of 3 per cent positive predictive values were integrated. This study aimed to examine whether current pan-London urgent referral guidelines for suspected head and neck cancer lead to efficient and accurate referrals by assessing frequency of presenting symptoms and risk factors, and examining their correlation with positive cancer diagnoses.<\/jats:p><\/jats:sec><jats:sec id=\"S002221511900149X_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>The risk factors and symptoms of 984 consecutive patients (over a six-month period in 2016) were collected retrospectively from urgent referral letters to University College London Hospital for suspected head and neck cancer.<\/jats:p><\/jats:sec><jats:sec id=\"S002221511900149X_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Only 37 referrals (3.76 per cent) resulted in a head and neck cancer diagnosis. Four of the 23 recommended symptoms demonstrated statistically significant results. Nine of the 23 symptoms had a positive predictive value of over 3 per cent.<\/jats:p><\/jats:sec><jats:sec id=\"S002221511900149X_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>The findings indicate that the current referral guidelines are not effective at detecting patients with cancer. Detection rates have decreased from 10\u201315 per cent to 3.76 per cent. A review of the current head and neck cancer referral guidelines is recommended, along with further data collection for comparison.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s002221511900149x","type":"journal-article","created":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T07:12:32Z","timestamp":1564729952000},"page":"704-712","source":"Crossref","is-referenced-by-count":9,"title":["Two week wait referral criteria \u2013 heading in the right direction?"],"prefix":"10.1017","volume":"133","author":[{"given":"C","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Freeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Oskooee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,8,2]]},"reference":[{"key":"S002221511900149X_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2015.09.041"},{"key":"S002221511900149X_ref7","unstructured":"National Institute for Health and Care Excellence Guideline. National Collaborating Centre for Cancer. Suspected cancer: recognition and referral. 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Head and neck cancers incidence statistics. 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Lung and pleural cancers - recognition and referral. In: https:\/\/cks.nice.org.uk\/lung-and-pleural-cancers-recognition-and-referral#!scenario [28 November 2018]"},{"key":"S002221511900149X_ref2","unstructured":"Department of Health and Social Care. The New NHS. 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