{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:19:07Z","timestamp":1777501147677,"version":"3.51.4"},"reference-count":11,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215121002061_sec_a1\"><jats:title>Background<\/jats:title><jats:p>The two-week-wait head and neck cancer referral pathway was introduced by the Department of Health, and refined through National Institute for Health and Care Excellence guidelines which were updated in 2015.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215121002061_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted of two-week-wait referrals to out-patient ENT from January to June 2018. The analysis included demographics, referral symptoms according to National Institute for Health and Care Excellence 2015 guidelines, cancer pick-up rates and positive predictive values.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215121002061_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>A total of 1107 patients were referred for suspected head and neck cancer over six months, with 6 per cent diagnosed with cancer. Neck lump, persistent hoarseness and throat pain were the most common presenting symptoms. Neck lump had the highest positive predictive value, followed by oral swelling. Oral bleeding and persistent unilateral sore throat showed significant positive predictive values. Investigation for metastatic head and neck cancer of an unknown primary or the involvement of other multidisciplinary teams could hinder the achievement of a 62-day treatment target.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215121002061_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>The cancer pick-up rate from two-week-wait referrals is only 1.5 times higher than routine referrals. The \u2018red flag\u2019 symptoms given in the 2015 National Institute for Health and Care Excellence update would benefit from further review.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215121002061","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T05:08:11Z","timestamp":1628140091000},"page":"869-873","source":"Crossref","is-referenced-by-count":15,"title":["Outcome of two-week head and neck cancer pathway for the otolaryngology department in a tertiary centre"],"prefix":"10.1017","volume":"135","author":[{"given":"B","family":"Mettias","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Charlton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Ashokkumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"S0022215121002061_ref10","first-page":"182","article-title":"The 2-week wait head and neck cancer referrals: is this system working","volume":"6","author":"Pracy","year":"2013","journal-title":"The Otorhinolaryngologist"},{"key":"S0022215121002061_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13511"},{"key":"S0022215121002061_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12597"},{"key":"S0022215121002061_ref2","unstructured":"2 NICE. Head and neck cancers - recognition and referral. In: https:\/\/cks.nice.org.uk\/head-and-neck-cancers-recognition-and-referral\/ [4 September 2019]"},{"key":"S0022215121002061_ref4","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215108002004"},{"key":"S0022215121002061_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2006.00607.x"},{"key":"S0022215121002061_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S002221511900149X"},{"key":"S0022215121002061_ref6","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2018.0168"},{"key":"S0022215121002061_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2007.10.010"},{"key":"S0022215121002061_ref11","first-page":"4920514","article-title":"Persistent unilateral sore throat: should it be included in the 2-week wait referral criteria by NICE","volume":"5","author":"Allam","year":"2019","journal-title":"Int J Otolaryngol"},{"key":"S0022215121002061_ref1","unstructured":"1 Cancer Research UK. In: https:\/\/www.cancerresearchuk.org\/ [4 September 2019]"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215121002061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T12:59:38Z","timestamp":1632920378000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215121002061\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,5]]},"references-count":11,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["S0022215121002061"],"URL":"https:\/\/doi.org\/10.1017\/s0022215121002061","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,5]]}}}