Missed cancer in the Danish head and neck cancer fast-track program: results from a tertiary cancer center

Figures & data

Figure 1. Flowchart describing the identification of the patients with missed cancer.

Table 1. Comparison of the first and second fast-track course for the ten cases of missed cancer.

Patient no.	Fast-track course	Diagnosis	Biopsy or FNA	Diagnostic imaging	Time between courses
1	First course	Sjogren’s syndrome. Infection in salivary gland.	No	None	2 years 9 months
	Second course	Lymphoma in salivary gland	Yes	PET/CT
2	First course	Multinodular goiter	Yes	None	2 years 4 months
	Second course	Thyroid carcinoma. Presents with metastasis in scapula	Yes	PET/CT
3	First course	Tonsillar hypertrophy	No	PET/CT	0 years 4 months
	Second course	Tonsillar carcinoma	Yes	PET/CT
4	First course	Hypertrophy of lingual tonsils	Yes	PET/CT, MRI Chest x-ray	2 years 3 months
	Second course	Oropharyngeal carcinoma	Yes	PET/CT, MRI Chest x-ray
5	First course	Benign parotid tumor	Yes	PET/CT, MRI, Chest X-ray	1 year 9 months
	Second course	Salivary gland sarcoma Histopathology revised at another hospital.	–	PET/CT, MRI, Chest X-ray
6	First course	Tonsillar hypertrophy	Yes	PET/CT, MRI, Chest x-ray	1 year 3 months
	Second course	Oropharyngeal carcinoma	Yes	PET/CT, MRI
7	First course	Lymphadenopathy	Yes	PET/CT	0 years 4 months
	Second course	Thyroid carcinoma. Presents with lymph metastasis	Yes	PET/CT
8	First course	Laryngitis	No	None	0 years 3 months
	Second course	Supraglottic laryngeal carcinoma	Yes	PET/CT, Chest x-ray
9	First course	Lymphadenopathy	Yes	PET/CT	0 years 2 months
	Second course	Lymphoma	Yes	PET/CT
10	First course	Dysphagia	No	None	1 year 11 months
	Second course	Oropharyngeal carcinoma	Yes	PET/CT

FNA: fine needle aspiration cytology.

Table 2. Characteristics of the patients with missed cancer.

Sex, n (%)
Female	4 (40%)
Male	6 (60%)
Age at first visit (years)
Youngest	48
Eldest	88
Median	64
Time between first and second course (days)
Shortest	42
Longest	1027
Median	464
Cancer site, n (%)
Oropharynx	4 (40%)
Thyroid	2 (20%)
Lymphoma	2 (20%)
Larynx	1 (10%)
Salivary gland	1 (10%)

Figure 2. Comparison of diagnostic groups for patients rejected from the fast-track program because cancer was not found. Group 1 = no biopsy or imaging. Group 2 = biopsy and/or imaging. Negative diagnosis = no cancer found.

Data availability statement

The local quality database for HNC and access to medical records were used under license and thus are not publicly available. Restrictions apply to the availability due to it containing identifiable patient data. Derived de-identified supporting the findings of this study are available from the corresponding author upon reasonable request.