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Urgent GP referrals boosting cancer diagnosis rates

But rate of screen detected bowel cancers remains low

Caroline White

Thursday, 18 January 2018

Two-week urgent GP referrals are helping to boost cancer diagnosis rates, reveal the latest set of data from Routes to Diagnosis, published by the National Cancer Registration and Analysis Service.

The dataset now includes 10 years’ worth of information, covering more than three million cancer cases, making it the most comprehensive dataset of its kind.

It groups patients into one of eight routes: screen detected; emergency presentation; two-week wait; GP referral; other outpatient; inpatient elective; death certificate only; unknown.

The data show that the way in which some cancers are being diagnosed has improved across England, with fewer made when patients present as an emergency. But the data also pinpoint areas where improvements still need to be made.

They show that diagnoses from emergency care presentations, where outcomes are the worst, fell from 24 per cent to 20 per cent between 2006 and 2015.

Diagnoses made as a result of urgent GP two-week referrals have risen significantly from 25 per cent in 2005 to 37 per cent in 2015, meaning that around 110,000 cases are now diagnosed this way.

Diagnoses of pancreatic cancer through emergency care presentation, which have the very worst outcomes have also fallen by six per cent.

But diagnoses of colorectal cancers made through the national bowel screening programme—the route with the best survival rate—remain under 10 per cent.

And the number of cancer cases diagnosed in Accident and Emergency varies widely across the country, ranging from fewer than one in 10 of all cases in the Peninsular Cancer Alliance to one in five of all cases in the London Cancer Alliance. This is despite similar numbers of new cases in both regions.

This latest update also includes a new interactive tool which, for the first time, shows trends in cancer diagnosis for 53 different types of cancer. This will enable doctors and managers to quickly and easily see the differences between cancers and understand where survival rates are improving.

Dr Jem Rashbass, Cancer lead at Public Health England said: “Diagnosing cancer earlier is one of the most important ways to improve cancer survival and we know that those patients who have their cancer diagnosed as an emergency have poorer outcomes. In England we have pioneered the analysis of routes to diagnosis data which allows us to highlight where we are making an impact and where challenges still remain.”

Sir Harpal Kumar, Cancer Research UK’s chief executive, said: “The earlier cancer is detected, the greater the chance that treatment will be successful. This Routes to Diagnosis data is an invaluable tool to see how we can [do that].”

He continued: “We’re pleased to see that the proportion of people who are diagnosed as an emergency has fallen, but with 40,000 cancers still diagnosed in A&E each year in England we know that more improvement is needed.”

Julia Tugwell, cervical cancer survivor said: “I believe that if a GP or other healthcare professional had questioned me directly about my lack of screening attendance, over many years, I would have been more likely to have attended.”

The new data shows that three-year survival for cervical cancer following a screening diagnosis is 95 per cent, compared to 65 per cent when picked up through the two-week referral– when symptoms might indicate more advanced disease.

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