Royal Marsden researchers to trial new referral pathway

Researchers at The Royal Marsden NHS FT have launched a trial to develop a new pathway that aims to speed up diagnosis and reduce anxiety for patients with suspected head and neck cancer.

The EVEREST-HN trial launches this month to investigate whether assessing each patient’s risk using a risk stratification tool before they are seen by a specialist will improve outcomes.

It involves working with patients and other interested parties to develop and implement a new pathway for suspected head and neck cancer referrals, based around the patient and their symptoms.

In the pathway the hospital with contact the patient after receipt of the referral and provide a questionnaire for them to complete about their symptoms. The trust plans to develop a risk stratification system, which the researchers said is “based on thousands of new referrals that will be assessed as part of our development and feasibility work”.

The researchers noted: “Using this system, higher-risk patients may have targeted investigations arranged directly, before being seen in clinic, and lower-risk patients may avoid unnecessary investigations and hospital appointments before being reassured. We will compare this new pathway to the existing system to ensure it is safe in identifying just as many cases of cancer, while also leading to faster diagnosis, reducing patient anxiety and using healthcare resources more efficiently.”

Amy O’Reilly, Trial Manager, added: “We’ll ask patients across 52 centres to complete an electronic questionnaire about their symptoms before being seen by a specialist, who will review this information to determine how they should be managed based on their individual risk.

“This could mean that high-risk patients have targeted investigations arranged before being seen in the clinic to ensure that treatment starts urgently if they have cancer. It could also mean lower-risk patients are reassured sooner that it’s unlikely they have cancer, while avoiding unnecessary tests and appointments.”

EVEREST-HN is supported by the International Centre for Recurrent Head and Neck Cancer, with funding from The Royal Marsden Cancer Charity and the National Institute for Health and Care Research.