Introduction
Approximately 760 people are diagnosed with head and neck cancer annually in Ireland. Little has been published nationally on the referral pathway these patients follow and no Irish guidelines exist for timeline benchmarking. Mapping the pathway and evaluating its current operating state are key to service evaluation and determining benchmarks for future practice.
Methods
This was a collaborative project between MSD Ireland and St James Hospital (SJH). SJH provided anonymised patient data from new cancer diagnoses in 2019. MSD provided statistical analysis and interpretation. Mean intervals between process steps and the level of process control were determined.
Results
Records from 386 patients were analysed. 281 met inclusion criteria. The majority (41.3%, n=116) were oral cavity lesions, followed by oropharyngeal (18.1%, n=51), and laryngeal (16.4%, n=46). 82.2% (n=231) were squamous cell carcinoma. Mean intervals were: referral to first review by the treating team 16.5 days, review to biopsy 9.2 days (median 0), review to CT/MRI/PET imaging 14.2/12.2/15.7 days, and referral to treatment commencing 49.9 days. Upper control limits were set at 3σ. All process steps were in a state of control.
Conclusions
This data will guide future monitoring of the pathway locally and the development of key performance indicators.