Deprivation in relation to urgent suspicion of head and neck cancer referrals in Glasgow

• Published in: Clinical otolaryngology 2018-06, Vol.43 (3), p.861-867
• Main Authors: Zeitler, M., Fingland, P., Tikka, T., Douglas, C.M., Montgomery, J.
• Format: Article
• Language: English
• Subjects: Cancer; Demographics; Demography; Deprivation; Females; Head & neck cancer; head and neck neoplasm; Males; Patients; symptoms; urgent 2‐week referrals
• ISSN: 1749-4478; 1749-4486
• DOI: 10.1111/coa.13077

Aim To examine deprivation measured by the Scottish index of multiple deprivation (SIMD) and its relation to urgent suspicion of head and neck cancer referrals. A secondary aim was to examine the symptomatology generating urgent suspicion of cancer (USOC) referrals by SIMD category. Methods All “urgent suspicion of cancer” referrals to the GGC ENT department over a one‐year period, between 2015 and 2016, were reviewed. Information was recorded anonymously and included demographics and red flag referral symptoms. Results A total of 1998 patients were assessed, 43.4% (n = 867) were male. A total of 171 (8.6%) patients had primary head and neck cancer. A total of 61 patients had other types of cancer, giving an all cause cancer rate of 11.6%. About 71.3% of primary patients with head and neck cancer (HNC) were male. The most common SIMD category observed was SIMD1, the most common SIMD category yielding a primary head and neck cancer diagnosis was SIMD1. Neck lump was the commonest symptom amongst all SIMD categories. Conclusion A link between deprivation and USOC referrals has been established. A difference in gender distribution between referrals and HNC was observed, more females are referred but a significantly higher number of patients with HNC are males. Neck lump is a very strong referral indicator for HNC and intermittent hoarseness is not. The findings from this analysis could be used to refine local referral patterns and priority of referral.