A team of UK surgeons and scientists have developed an updated version of the head and neck cancer risk calculator (HaNC-RC) which increases the tool’s predictive power from 77% with the original version to 88.6%.
The updated version has the potential to reduce the number of inappropriate referrals to the 2-week-wait urgent suspicion of cancer (USOC) pathway. This is important given that the USOC pathway has not increases early HNC detection rates. Only 35%-38% of HaNC cases in the UK are currently diagnosed via the 2-week-wait pathway.
The HaNC RC v.2 includes smoking (current, ex-smoker, non-smoker) and alcohol history (>14units/week, ≤14units/week, previous excess), which were not included in the original version. The new version also includes significant symptoms such as sore throat, unintentional weight loss, stridor and HaN skin lesion, and refined symptoms already in the risk calculator.
The revised calculator achieved an area under the curve (AUC) of 88.6% with two recommended triage referral cut-offs (cut-off 7.1%; sensitivity 85%; specificity 78.3%) or urgent clinics (cut-off 2.2%; sensitivity 97.1%; specificity 52.9%).
The team say the updated calculator could redistribute cancer detection through USOC clinics from the current 60.9% to 85.2%, without affecting total numbers seen in each clinical setting.
