ArticleClinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery2020
Head and neck cancer risk calculator (HaNC-RC)-V.2. Adjustments and addition of symptoms and social history factors.
Article in Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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34 citing papers in PubMed, 67 citations in OpenAlex.
- Telephone and 'Straight-to-Test' Model in Triaging Urgent Suspected Cancer Referrals in a Head and Neck Clinic.Cureus · 2026Article
- A nurse-led telephone clinic can safely triage suspected head and neck cancer referrals using the head and neck risk calculator.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Validation and Extension of a Risk Calculator to Predict Mood Recurrence in Young People with Bipolar Disorder.medRxiv : the preprint server for health sciences · 2026Article
- The incidence of avid lesions in head and neck cancer patients undergoing positron emission tomography-computed tomography scanning.The Journal of laryngology and otology · 2026Article
- Feasibility and Safety of Allied Health Professional Delivered Clinics for Suspected Head and Neck Cancers: A Scoping Review.Laryngoscope investigative otolaryngology · 2026Review
- Co-design of clinician-facing report and implementation pathway for a digital questionnaire for reporting head and neck cancer symptoms.JAMIA open · 2025Article
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- Genetic, clinical, lifestyle and sociodemographic risk factors for head and neck cancer: A UK Biobank study.PloS one · 2025Article
- Machine Learning in Clinical Diagnosis of Head and Neck Cancer.Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2025Observational
- A novel remote assessment pathway to streamline the management of two-week-wait suspected head and neck cancer referrals: a prospective analysis of 660 patients.The Journal of laryngology and otology · 2024Article
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- Implementation of the Symptom Based Risk Calculator for Head and Neck Cancer HaNC-RC v.2 Post COVID-19 Pandemic. A Single Centre Audit.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2024Article
- Nomenclature of the symptoms of head and neck cancer: a systematic scoping review.Frontiers in oncology · 2024Article
- The impact of 2 weeks wait referral on survival of head and neck cancer patients.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023Article
- Is the early identification and referral of suspected head and neck cancers by community pharmacists feasible? A qualitative interview study exploring the views of patients in North East England.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- Impact of COVID-19 pandemic on head-neck cancer referral and treatment pathway in North East London.Annals of the Royal College of Surgeons of England · 2023Article
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- Risk prediction models for head and neck cancer: A rapid review.Laryngoscope investigative otolaryngology · 2022Review
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesHead and neck cancer (HNC) diagnosis through the 2-week wait, urgent suspicion of cancer (USOC) pathway has failed to increase early cancer detection rates in the UK. A head and neck cancer risk calculator (HaNC-RC) has previously been designed to aid referral of high-risk patients to USOC clinics (predictive power: 77%). Our aim was to refine the HaNC-RC to increase its prediction potential.
designFollowing sample size calculation, prospective data collection and statistical analysis of referral criteria and outcomes.
settingLarge tertiary care cancer centre in Scotland.
participants3531 new patients seen in routine, urgent and USOC head and neck (HaN) clinics.
main outcome measuresData collected were as follows: demographics, social history, presenting symptoms and signs and HNC diagnosis. Univariate and multivariate regression analysis were performed to identify significant predictors of HNC. Internal validation was performed using 1000 sample bootstrapping to estimate model diagnostics included the area under the receiver operator curve (AUC), sensitivity and specificity.
resultsThe updated version of the risk calculator (HaNC-RC v.2) includes age, gender, unintentional weight loss, smoking, alcohol, positive and negative symptoms and signs of HNC. It has achieved an AUC of 88.6% with two recommended triage referral cut-offs to USOC (cut-off: 7.1%; sensitivity: 85%, specificity: 78.3%) or urgent clinics (cut-off: 2.2%; sensitivity: 97.1%; specificity of 52.9%). This could redistribute cancer detection through USOC clinics from the current 60.9%-85.2%, without affecting total numbers seen in each clinical setting.
conclusionsThe use of the HaNC-RC v.2 has a significant potential in both identifying patients at high risk of HNC early thought USOC clinics but also improving health service delivery practices by reducing the number of inappropriately urgent referrals.
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