A new study has found no evidence that the current system of referral from general practitioners (GPs) to primary care dentists shortens time to diagnosis for oral squamous cell carcinoma (OSCC). The finding calls into question NICE recommendations for GPs to refer patients to dentists, the authors say.
In the focussed systematic review, researchers retrieved studies looking at OSCC diagnosis from when patients first accessed primary care up to referral, including length of delay and stage of disease at time of definitive diagnosis. From 538 records identified in a search of five databases up to March 2018, total of 16 articles were eligible for full-text review.
Based on the evidence, the researchers say more than 55% of patients with OSCC are referred by a GP and 44% are referred by a dentist. There was no clear difference between GP-referred and dentist-referred patients in relation to stage of disease at diagnosis or delay in referral. Most referrals were found to be timely.
However, less than half of the studies could describe the detailed circumstances surrounding referral, and there was no information concerning inter-GP-dental referrals, as recommended by NICE oral cancer guidelines.
Presenting the findings in the British Journal of General Practice, the authors say that, based on the studies reviewed, they did not find any evidence for the need for this pathway. However, they stress that there is a little research in this area and they urge “clinically curious GPs and dentists” to publish in this area and report on best pathways to early diagnosis.
