Lymphoma presenting as neck lumps: causes of waiting time target breaches and potential solutions

J Laryngol Otol. 2013 Nov;127(11):1111-5. doi: 10.1017/S0022215113002466. Epub 2013 Nov 4.

Abstract

Objectives: This study aimed to assess the speed of referral, diagnosis and treatment of patients with lymphoma presenting with a neck lump, and to identify where delays are occurring that prevent UK national targets from being met.

Method: The study entailed a retrospective survey of patients presenting with a neck lump secondary to lymphoma between 2006 and 2008 in Gloucestershire, UK.

Results: Forty-seven of 54 patients (87 per cent) were seen within 2 weeks of referral. However, the 62-day rule, which covers the time from referral to the initiation of treatment, was met in only 32 of the 54 cases (59 per cent). There were no breaches of the 31-day target, which concerned the time from decision to treat to the initiation of treatment. Subsequent target breaches were due to longer waiting times for radiological and pathological investigations.

Conclusion: Radiological examinations should be ordered at the first consultation and biopsies performed as soon as possible. Establishing one-stop, rapid access clinics should improve the achievement of a maximum 62-day wait for patients with lymphoma presenting with neck lumps.

MeSH terms

  • Biopsy, Fine-Needle / statistics & numerical data
  • Early Detection of Cancer
  • England
  • Head and Neck Neoplasms / diagnostic imaging
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Lymphoma / diagnostic imaging
  • Lymphoma / surgery*
  • Radiography
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • Time-to-Treatment*
  • Waiting Lists*