Quicker referral of patients with unexplained swollen neck glands for specialist investigations could help to avoid some of the thousands of deaths each year from lymphoma, according to two studies.
Waiting for the currently-accepted six weeks before referring adults with persistent lymphadenopathy is too long, according to UK research on non-Hodgkin’s and Hodgkin’s lymphoma.
“We now hope that this research will feed into guidelines”
Using large datasets, researchers identified and quantified the clinical features of these lymphomas presenting in primary care for the first time.
Patients over the age of 60 with lymphadenopathy and masses elsewhere were found to be at particularly high risk of lymphoma and should be referred with little delay, said the study authors.
One study, published in the British Journal of General Practice, looked at non-Hodgkin’s cases diagnosed between January 200 and December 2009. The data provided 4,799 cases, with more than 19,000 controls.
The second study, published in the same journal, assessed 283 patients over the age of 40 with Hodgkin lymphoma, comparing them with 1,237 control cases.
The two associated studies were carried out by the University of Exeter working with colleagues in the universities of Oxford, Cambridge and Bangor
The findings from both studies demonstrated the importance of swollen lymph glands, particularly in the neck.
Based on the findings from the first study, the researchers said unexplained lymphadenopathy in older patients indicated a “very high risk” of non-Hodgkin’s lymphoma in primary care, and should “warrant urgent investigation”.
In addition, they said lymphadenopathy was the clinical feature with the “highest risk” of Hodgkin’s lymphoma in primary care and warrants urgent investigation.
However, they noted that more than 40% of patients currently visited their GP with symptoms three or more times before being referred for cancer investigations.
Dr Liz Shephard, who led both studies, said: “Early diagnosis is vital to reducing cancer deaths. We now hope that this research will feed into guidelines.”