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The time taken to confirm a diagnosis of suspected cancer may be reduced in a new approach by Health Technology Wales. 

Patients in Wales could benefit from a new approach which reduces time taken to diagnose cancer, and saves money for the NHS. 

Having completed their appraisal (named “pharyngolaryngeal biopsy under local anaesthesia for people with suspected head and neck cancer in the outpatient setting”), Health Technology Wales announced the positive result. 


The topic, proposed by Olympus, has been undergoing full appraisal since late 2021, following the publication of a Topic Exploration Report.

Overall, the panel concluded that outpatient biopsy under local anaesthetic should be recommended for routine adoption as a first step in the diagnostic pathway for head and neck cancer in appropriate and consenting patients, since it has the potential to reduce the time to diagnosis and treatment for some patients with cancer.

Wales cancer cases

In Wales, there are around 500 new cases of head and neck cancers reported each year. 

Before the COVID-19 pandemic, around 800 patients each year underwent a pharyngolaryngeal biopsy procedure under general anaesthetic in an operating theatre across Wales. 

Many of these patients could now benefit from this new approach, which reduces their wait for a confirmed diagnosis and, where positive, can reduce their time to treatment commencing.

Health Technology Wales found that the time between consultation and diagnosis could be reduced, on average, by more than two weeks (15.5 days).

The Health Technology Wales guidance states:

 “The evidence supports the adoption of pharyngolaryngeal biopsy under local anaesthesia to confirm, but not to rule out, a diagnosis of head and neck cancer.

“This procedure can be done in an outpatient setting and avoids the need for inpatient care and general anaesthesia. 

“A positive result has the potential to accelerate the initiation of treatment, but a negative result should be followed by a second biopsy in an operating theatre under general anaesthesia.

“Economic modelling estimates that there is the potential for cost saving through the use of pharyngolaryngeal biopsy under local anaesthesia rather than in a theatre environment under general anaesthesia and that this is a cost-effective procedure.”

Dr Susan Myles, Director of Health Technology Wales, said: “Health Technology Wales produces national guidance on the use of non-medicine health technologies in Wales. Our aim is to drive improvements in population health and social care.

“We looked for evidence on the effectiveness of pharyngolaryngeal biopsies in the outpatient setting for people with suspected head and neck cancer after the topic was submitted to us by Olympus.

“The evidence showed that pharyngolaryngeal biopsies can be done under local anaesthetic without needing to wait for a surgery slot, which could lead to a quicker diagnosis of cancer, and could allow for quicker treatment.

Our guidance concludes that the evidence supports the adoption of pharyngolaryngeal biopsy under local anaesthesia to confirm, but not to rule out, a diagnosis of head and neck cancer.”

Early detection and diagnosis, alongside timely intervention, is essential for improving outcomes for suspected cancer patients. 

“The NHS in Wales has faced a challenge with timely intervention in recent times for patients on the suspected cancer pathway. The publication of this guidance can provide Local Health Boards with an opportunity to reduce the time between suspicion and first treatment by aiding in a quicker diagnosis.

 Alex Zervakis, general manager, Health Economics & Market Access, Olympus UK & Ireland, added: “We are absolutely delighted with the outcome of this appraisal. It’s fantastic to see how technology has the potential to enable more timely care for patients and help drive down costs for the NHS.

“We hope to see strong adoption of this new approach across Wales, enabling many patients to benefit from a faster diagnosis and quicker access to treatment.”

Health Technology Wales (HTW) research and evaluate the best available clinical and cost-effectiveness evidence about a health technology.

Read more about the Health Technology Appraisal (HTA) process here.   

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  1. Pingback: Irish oncology care platform teams up with NCCN to develop digital tool - Health Tech World

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