Abstract

Aim: To compare the compliance to and effectiveness of the two-week wait rule for detecting urgent suspected oral cancers over one year period in East Sussex Healthcare NHS Trust with contemporaneous published data from studies undertaken in regional and international Oral and Maxillofacial departments to highlight areas for change in local practice in terms of referral protocol and further education of practitioners. Method: From September 2014 to August 2015, the records of 158 patients referred under the two-week wait rule were collected retrospectively. Data collected included date of the initial referral, first consultation, diagnosis/signing of consent form, treatment(s) undertaken and whether there was a dysplasia/malignancy. Results: From the 158 patients, ten patients were found to the have oral cancer (6.3%). There was a compliance of 96.2% for patients to be seen within two weeks of the referral. The mean average waiting time was 7.6 days for the first appointment. The “decision to treat” date to operation average interval was 29 days (range 17-62 days). The mean interval of receipt of “referral to treatment” was 71 days (range 40-97 days). Six of the patients (60%) were treated with excisional biopsy and four patients with neck dissection and reconstruction. Patients between the ages 40 to 49 years old made up half of the sample. There was no difference in incidence in disease on a month-by- month basis. Conclusions: These results and findings were consistent with other national and international studies demonstrating both compliance with the two week “referral to treatment” rule and the detection rate of oral cancer. Public awareness campaigns and further education for primary care practitioners, as well as an update referral online system, are recommended to improve the detection rate and efficiency of the two-week wait rule