Facial surgeons call for review of two week cancer referral system

BMJ 2016; 352 doi: (Published 17 February 2016) Cite this as: BMJ 2016;352:i1006
  1. Jacqui Wise
  1. London

Facial surgeons have called for an urgent review of the two week fast track cancer referral system, saying that it is overwhelming the NHS and delaying access to treatment for patients who actually have head and neck cancer.

Their warning comes as a systematic review, published in the British Journal of Oral and Maxillofacial Surgery, showed that as few as 6.6% of fast track GP referrals for head and neck cancer turn out to be cancers.1 And a separate study in the same journal showed that the 2015 National Institute for Health and Care Excellence (NICE) referral guidelines for head and neck cancer were overly sensitive and not specific enough.2

The British Association of Oral and Maxillofacial Surgeons said that the two week referral system was not based on evidence. They also claimed that the problem was not confined to head and neck cancer because other studies had shown that, with breast, gastrointestinal, and colorectal cancer, the proportion of patients referred within two weeks who turn out to have cancer rarely exceeds 10%. …

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