ThP3.1 - Dysphagia: Should we be going straight to scope? A retrospective analysis within a single Scottish District General Hospital

Abstract Aim Dysphagia is the main symptom in patients with oesophageal cancer. British Society of Gastroenterology guidelines state that all patients with an Edinburgh Dysphagia score (EDS) of >3.5 should be investigated with an urgent oesophagogastroduodenoscopy (OGD) for suspicion of cancer. We aim to investigate the outpatient clinic outcome for patients referred with dysphagia. Methods A retrospective cohort study of all urgent suspicion of cancer (USOC) referrals with dysphagia between April to September 2022. Patients demographics, clinic outcome and waiting time for OGD were analysed. This study was registered with Clinical Quality Project (LanQIP 14747). Results 138 (37.5%) of 361 USOC referrals had dysphagia. Median age was 63 years (IQR 51-72) and 78 (56.5%) were female. Median Scottish Index of Multiple Deprivation was 4 (IQR 2-6). 3 (2.2%) patients were referred straight to scope. 125 (90.6%) patients attended clinic, of these 106 (84.8%) patients had an OGD requested. 84 (67.2%) were requested urgently, 16 (12.8%) routinely and 25 (20%) did not receive a scope. The median waiting time to clinic was 42 days (IQR 62-31) and median time from clinic to OGD was 36 days (IQR 24-59). Total waiting time from the referral to OGD was 81 days (IQR 62-111). Conclusions The majority of patients presenting with dysphagia will necessitate urgent OGD following clinic consultations. Therefore, to expedite the diagnostic process, implementing a direct referral pathway to endoscopy, bypassing clinic wait times, is recommended.