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Purpose To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. Methods Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. Results Twenty-four sections on HNC-specific OD topics. Conclusion This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.

Purpose: Demographic transformations within the UK population combine to contribute to a substantial increase in demand for low vision (LV) services, creating a pressing need to reconsider the appropriate methods for service provision. In this study, we evaluate the feasibility of using telephone triage to assess the need for, and timing of, LV follow-up appointments. Methods: A cohort of new patients attending the LV Clinic at Manchester Royal Eye Hospital (MREH) was recruited, independent of vision or visual impairment (VI) registration status. Four weeks after this initial clinic assessment, each patient was telephoned and a structured review was conducted. All patients were subsequently followed up at 3 months in the LV clinic. Results: A total of 52 patients were recruited, with the corrected ‘better-eye’ visual acuity (VA) ranging from 0.18 logMAR (6/9.5 + 1) to 1.36 logMAR (6/152 + 2) with a mean of 0.66 logMAR (6/30 + 2). In total, 36 patients completed all aspects of the study. At telephone review, 70 (93%) of the low vision aids (LVAs) loaned were reported to have been used on at least one occasion. Ten patients (22%) were deemed to not require follow-up, 15 (33%) were judged to benefit from an earlier (1 month) review, and 16 (35%) were judged to require 3-month follow-up. Reminding patients at telephone review provided a significant increase in adherence with advice to bring any loaned devices to clinic review ( p < 0.01). Face-to-face clinic review outcomes at 3 months permitted some insight into the effectiveness of telephone triage. Conclusions: Implementing telephone review is feasible for triaging LV follow-up requirements. A number of patient issues can be dealt with immediately and effectively at telephone review, potentially negating the need for a face-to-face clinic review for some patients while identifying a more pressing need for earlier review in others, factors that might improve cost-effectiveness of service provision if subjected to formal health economic evaluation.