Rapid access clinics for head and neck cancer: impact on diagnostic and treatment timelines in a regional centre

Background: Head and neck cancer (HNC) presents many significant treatment and planning challenges due to high morbidity and mortality rates and significant psycho-social burdens that accompany the diagnosis. Early diagnosis is crucial for optimal outcomes, yet many patients experience delays, often leading to advanced-stage disease at presentation and diagnosis. To evaluate the implementation and outcomes of a rapid access HNC clinic and theatre [rapid access clinic (RAC)] pathway at an Australian Tertiary Centre, focusing on diagnostic and treatment timelines.

Methods: A retrospective comparative cohort study was conducted. Patients seen through the RAC between July 2023 and June 2024 were compared to a control cohort of patients with HNC referred in 2019, prior to the RAC implementation. Primary outcomes included time from referral to initial review, time from initial review to diagnosis, and time from initial review to treatment.

Results: A total of 118 patients were evaluated through the RAC during the study period, with 50 confirmed malignancies, compared with 47 patients in the control cohort with head and neck malignancies. The median time from referral to first ears, nose and throat (ENT) review was reduced in the RAC group [16 days, interquartile range (IQR), 9–27 days] compared with controls [38 days, IQR, 13–50 days], representing a 57.9% reduction. Time from review to diagnosis was also shorter in the RAC group [6 days, IQR, 1–20 days] versus controls [14 days, IQR, 8–23 days] (57.1% reduction; Mann-Whitney U =807, z =−2.38, P=0.017). The time from review to initiation of treatment was 36 days (IQR, 22–47 days) in the RAC group and 49 days (IQR, 36–75 days) in controls (26.5% reduction; U =516, z =3.89, P<0.001).

Conclusions: The RAC model significantly expedited the diagnostic and treatment process for suspected HNC patients, aligning with national guidelines and international standards. Ongoing evaluation with prospective, multicentre, data and survival outcomes will further determine its broader clinical and policy impact.