Introduction of a referral pathway guide for general dental practitioners in Cheshire & Merseyside: the effect on two-week suspected cancer referrals

Introduction In 2017, Cheshire and Merseyside Local Dental Network introduced an Oral Cancer Care Guide for dental teams, emphasising the importance of early detection, appropriate referral, and effective patient communication. This study looks at the effect on two-week-wait (TWW) referrals to one unit, following the introduction of the guide and regional educational intervention.

Methods Somerset Cancer Register, provided data from two three-month cohorts of TWW suspected head and neck cancer referrals, before and after introduction of the guide.

Results There were 390 and 481 referrals respectively during the two three-month time-periods. The number of general dental practitioner (GDP) referrals rose from 24 to 59 (6.2% to 12.3%, P = 0.002) following introduction of the guide. The cancer conversion rate remained the same for general practitioner (GP) referrals (6.3% and 6.2%) but was lower for GDP referrals (21% vs 12%, P = 0.31).

Conclusions We observed an increase in referrals following the introduction of the guide; however, the conversion rate for GDP referrals reduced. Education and ease of referral are essential for reducing the number of advanced cancers presenting to secondary care, but more research is required to inform an improvement in specificity. Future work is required looking at the long-term impact of the guide including adaption for local GP usage.