Abstract
Background
The UK has poorer cancer survival than some other developed countries. UK diagnostic intervals may be longer and health service organization, which differs between UK countries could be a determining factor. The National Cancer Diagnosis Audit explored primary care cancer diagnosis in Scotland and England.
Aim
To describe cancer diagnosis in Scottish primary care and draw some comparisons with cancer diagnostic activity in England.
Design and setting
National clinical audit of cancer diagnosis in Scottish and English general practice.
Method
Participating GPs collected diagnostic pathway data on patients diagnosed in 2014 from medical records. Data were supplemented by linkage to national cancer registries. Analysis explored and compared patient characteristics, diagnostic intervals, and routes to diagnosis.
Results
7.7% of all Scottish general practices in 2017 provided data on 2,014 cancer diagnoses. 71.5% of cases presented to GPs and 37.4% were referred using the “Urgent-Suspected Cancer” route. The median primary care interval was 5 days (IQR 0-23 days) and median diagnostic interval was 30 days (IQR 13-68). Both varied by cancer-site. Diagnostic intervals were longer in the most remote patients and those with more comorbidities. The Scottish and English samples corresponded closely in key characteristics.
Conclusions
Most people diagnosed with cancer in Scotland present to a GP first. Most are referred and diagnosed quickly, with variations by cancer-site. Intervals were longest for the most remote patients. GPs in Scotland and England appear to perform equally but, in view of growing differences between health systems, future comparative audits may be informative.
The UK has poorer cancer survival than some other developed countries. UK diagnostic intervals may be longer and health service organization, which differs between UK countries could be a determining factor. The National Cancer Diagnosis Audit explored primary care cancer diagnosis in Scotland and England.
Aim
To describe cancer diagnosis in Scottish primary care and draw some comparisons with cancer diagnostic activity in England.
Design and setting
National clinical audit of cancer diagnosis in Scottish and English general practice.
Method
Participating GPs collected diagnostic pathway data on patients diagnosed in 2014 from medical records. Data were supplemented by linkage to national cancer registries. Analysis explored and compared patient characteristics, diagnostic intervals, and routes to diagnosis.
Results
7.7% of all Scottish general practices in 2017 provided data on 2,014 cancer diagnoses. 71.5% of cases presented to GPs and 37.4% were referred using the “Urgent-Suspected Cancer” route. The median primary care interval was 5 days (IQR 0-23 days) and median diagnostic interval was 30 days (IQR 13-68). Both varied by cancer-site. Diagnostic intervals were longer in the most remote patients and those with more comorbidities. The Scottish and English samples corresponded closely in key characteristics.
Conclusions
Most people diagnosed with cancer in Scotland present to a GP first. Most are referred and diagnosed quickly, with variations by cancer-site. Intervals were longest for the most remote patients. GPs in Scotland and England appear to perform equally but, in view of growing differences between health systems, future comparative audits may be informative.
| Original language | English |
|---|---|
| Article number | e13234 |
| Number of pages | 15 |
| Journal | European Journal of Cancer Care |
| Volume | 29 |
| Issue number | 3 |
| Early online date | 10 Mar 2020 |
| DOIs | |
| Publication status | Published - 1 May 2020 |
Bibliographical note
The National Cancer Diagnosis Audit (NCDA) in Scotland received enabling support from Cancer Research UK and the Scottish Government.ACKNOWLEDGEMENTSThis audit used data provided by patients and collected by the NHS as part of their care and support. The authors would like to thank all GPs and health professionals who participated in the NCDA in Scotland and England, the members of the NCDA Steering Group (National Cancer Diagnosis Audit (2014) Steering Group: Sue Ballard (patient †), Patricia Barnett, David H Brewster, Cathy Burton, Anthony Cunliffe, Jane Fenton-May,Anna Gavin, Sara Hiom(chair),Peter Hutchison, Dyfed Huws, Maggie Kemmner, Rosie Loftus, Georgios Lyratzopoulos,Emma McNair, John Marsh (patient), Jodie Moffat, Sean McPhail, Peter Murchie, Andy Murphy, Sophia Nicola, Imran Rafi, Jem Rashbass, Richard Roope, Greg Rubin, Brian Shand, Ruth Swann, Janet Warlow, David Weller and Jana Witt.) and contributing staff at Cancer Research UK; Information Services Division (NHS Scotland); Scottish Government; the National Cancer Registration and Analysis Service (Public Health England); NHS England; the Royal College of General Practitioners; and Macmillan Cancer Support
Keywords
- cancer
- clinical audit
- diagnosis
- delay
- morbidity
- primary care
- STAGE
Access to Document
- Murchie_etal_EJCC_Cancer_AAM
This is the peer reviewed version of the following article: Murchie, P, Adam, R, McNair, E, et al. Cancer diagnosis in Scottish primary care: Results from the National Cancer Diagnosis Audit. Eur J Cancer Care. 2020; 29:e13234., which has been published in final form at https://doi.org/10.1111/ecc.13234. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.