Outpatient biopsy for diagnosis of suspicious lesions of the larynx pharynx and tongue base

Recommendation for NHSScotland

Outpatient biopsy has a low rate of complications and, in most cases, sufficient tissue for pathological examination can be obtained. Where there strong clinical suspicion of malignancy, outpatient biopsy offers the possibility of a more rapid diagnosis and allows selected patients to avoid biopsy under general anaesthetic in the operating theatre.

The provision of outpatient biopsies is also likely to reduce laryngoscopy costs to the NHS, although initial investment will be required to purchase the additional equipment needed to obtain biopsies in the outpatient setting.

NHSScotland is required to consider the Scottish Health Technologies Group (SHTG) advice.

What were we asked to look at?

We were asked to provide advice on the clinical and cost effectiveness of outpatient biopsy based on published literature, and to carry out a budget impact analysis to assess the potential cost and
resource impact of outpatient biopsy. 

Why is this important?

The incidence of head and neck cancer is increasing. Reducing diagnostic delay is essential since early detection can improve prognosis and/or enable early initiation of appropriate care.

Referred by

Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde