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The 2-week rule for suspected head and neck cancer in the United Kingdom: Referral patterns., diagnostic efficacy of the guidelines and compliance

Lookup NU author(s): Dr David Meikle, Professor Peter Thomson, Andrew Welch, Professor Vinidh Paleri


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A retrospective audit of 1079 2-week referrals between 1 January 2004 and 31 December 2006 was undertaken. The aims of this audit were to assess compliance of referrals with Department of Health (DoH) guidelines; the effectiveness of the 2-week referral route in detecting head and neck cancers, and to determine whether this route identified more early stage cancers. Of 1079 2-week referrals, 71.5% conformed to DoH criteria. DoH guidelines were found to have a high sensitivity of 83.9% (75.5-89.7%, 95% Cl) for head and neck cancer, but a low positive predictive value of 12.8% (10.5-15.3%) and a specificity of 30.0% (27.2-33.1%). Only 10.9% of 2-week referrals were diagnosed with a head and neck cancer. The cancer detection rate was higher amongst referrals that conformed to DoH guidelines (12.8%) compared to those that did not 6.2%. This was statistically significant (Chi square, p

Publication metadata

Author(s): Mckie C, Ahmad UA, Fellows S, Meikle D, Stafford FW, Thomson PJ, Welch AR, Paleri V

Publication type: Article

Publication status: Published

Journal: Oral Oncology

Year: 2008

Volume: 44

Issue: 9

Pages: 851-856

ISSN (print): 1368-8375

ISSN (electronic): 1741-9409

Publisher: Pergamon


DOI: 10.1016/j.oraloncology.2007.10.010


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