A systematic review: impact of in-office biopsy on safety and waiting times in head and neck cancer

Alison E. Lim (Lead / Corresponding author), Alexander D. G. Rogers, Mervyn Owusu-Ayim, Sushil Rodrigues Ranjan, Jaiganesh Manickavasagam, Jenny Montgomery

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)
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Objective: This study aimed to assess the current literature on the safety and impact of in-office biopsy on cancer waiting times as well as review evidence regarding cost-efficacy and patient satisfaction.

Method: A search of Cinahl, Cochrane Library, Embase, Medline, Prospero, PubMed and Web of Science was conducted for papers relevant to this study. Included articles were quality assessed and critically appraised.

Results: Of 19 741 identified studies, 22 articles were included. Lower costs were consistently reported for in-office biopsy compared with operating room biopsy. Four complications requiring intervention were documented. In-office biopsy is highly tolerated, with a procedure abandonment rate of less than 1 per cent. When compared with operating room biopsy, it is associated with significantly reduced time-to-diagnosis and time-to-treatment initiation. It is linked to improved overall three-year survival.

Conclusion: In-office biopsy is a safe procedure that may help certain patients avoid general anaesthetic. It was shown to significantly reduce time-to-diagnosis and time-to-treatment initiation when compared with operating room biopsy. This may have important implications for oncological outcomes. In-office biopsy requires fewer resources and is likely to be cost-saving five-years following introduction. With high rates of sensitivity and specificity, in-office biopsy should be considered as the first-line procedure to achieve tissue diagnosis.
Original languageEnglish
Pages (from-to)909-916
Number of pages8
JournalJournal of Laryngology and Otology
Issue number10
Early online date10 Jan 2022
Publication statusPublished - Oct 2022


  • Head and Neck Neoplasms
  • Endoscopes
  • Biopsy
  • Safety
  • Diagnosis


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