Importance of quality in referral letters sent for potentially malignant oral, head and neck lesions Mital Patel Adeel Qutub Khan Janavikulam Thiruchelvam Dental Update 2024 38:3, 707-709.
Early diagnosis of oral, head and neck cancer is very important. Delay in diagnosis and referral to a specialist unit can result in an enlarged tumour with an increased chance of metastatic spread which will result in upstaging of the tumour, thus worsening the five year survival rate. There is a great need for early identification and referral of potentially malignant lesions by general dental and medical practitioners. Referral letters are the standard and, typically, the sole method of communicating confidential information between two professionals. It is vital that the referral letters sent for potential malignant lesions are of good quality, clearly marked as urgent and contain adequate administrative and clinical data. An audit was undertaken at the Oral and Maxillofacial Department at Barnet and Chase Farm NHS Trust, to examine the quality of referral letters sent for potentially malignant oral, head and neck lesions. The outcome is discussed and a standard referral letter is also proposed if not referring using the standard local cancer network referral proforma.
Clinical Relevance: A good quality referral letter should minimize delay in diagnoses and management of a patient with an oral, head and neck lesion.
Article
Oral, Head and Neck Cancer (OHNC) is a major health problem in many parts of the world. It is the third most common malignancy in the developing world after cancer of the stomach and cervix.1 Incidence of OHNC is low in western countries; however, in the Indian subcontinent and in other parts of Asia it may account for up to 50% of all new malignancies.2 In England and Wales, OHNC accounts for about 2–3% of all new malignancies each year and oral cancer alone makes up almost half of the reported cases.3 Over 90% of oral carcinomas are squamous cell carcinomas, which arise from the oral mucosal lining.2 The mortality and morbidity rate of OHNC is high and the quality of life of the survivors can be compromised with altered speech, chewing, swallowing and breathing. Disfigurement of the face, head and neck is also common, especially when diagnosed in late stages.4 It is therefore important that an early diagnosis is made. Regular screening of the oral tissues and an adequate and timely referral plays a major role in this.
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