Abstract
Objective. To characterise cancer diagnosis in Scottish primary care in 2018/19 and draw comparisons with diagnostic activity in 2014. Methods. A national audit of cancer diagnosis undertaken in Scottish general practices. Participating GPs collected diagnostic pathway data on patients diagnosed with cancer in 2018/19 from medical records. These data were supplemented by linkage to the Scottish Cancer Registry and previous audit data from 2014. Analyses explored and compared patient demographics, presentation, diagnostic routes, and intervals. Results. Seventy-three practices submitted data on 2,014 cases in 2014 and 90 practices submitted data on 2,318 cases in 2018/2019. Individual demographics and types of cancer were similar. There was a higher proportion of USC (urgent suspected cancer) referrals in 2019 than 2014 (42.9% vs 38.1%, ) but a similar proportion of emergency presentations (19.2% vs 20.4%). Primary care (median 4 (IQR 0–22) vs 5 (0–23)) and diagnostic intervals (27 (10–59) vs 30 (13–68)) were similar in both periods. Significantly fewer (24.5% vs 28.3, ) had a diagnostic interval >60 days in 2019 than 2014. Harder to diagnose cancers were more likely to present as emergencies and be subject to prolonged delays in both cohorts. Conclusions. The 2014 and 2018/19 cohorts were broadly similar. There is limited evidence that USC use had increased between 2014 and 2018/19. Harder to diagnose cancers are still most likely to present as emergencies and be subject to delays. Overall, it seems there were small improvements in cancer diagnosis prepandemic and a further audit could examine evidence for a postpandemic recovery.
| Original language | English |
|---|---|
| Article number | 1117968 |
| Number of pages | 13 |
| Journal | European Journal of Cancer Care |
| Volume | 2024 |
| Early online date | 14 Feb 2024 |
| DOIs | |
| Publication status | Published - 2024 |
Bibliographical note
AcknowledgmentsThe 2nd National Cancer Diagnosis Audit received enabling financial support from Cancer Research UK and the Scottish Government. This audit used data provided by patients and collected by 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 the members of the NCDA Steering Group, as well as contributing staff at Cancer Research UK, Information Services Division (NHS Scotland), Scottish Government, the Royal College of General Practitioners, and Macmillan Cancer Support.
Data Availability Statement
In compliance with all regulatory and legal requirements, data were stored, accessed, and analysed with the National Safe Haven maintained by NHS National Services Scotland. Outputs were subject to disclosure checks with members of the Electronic Data Research and Innovation (eDRIS) team of the Information and Statistics Division, Scotland, prior to release to the research team for inclusion in this manuscript. Any future access to this dataset would require application to the Scottish Government.
Access to Document
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Copyright © 2024 Susanne Maxwell et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/