Early results of the RCGP/NCAT National Audit of Cancer Diagnosis in Primary Care


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Sean McPhail1,Kathy Elliott2,Greg Rubin3
1NCIN, London, United Kingdom,2NCAT, London, United Kingdom,3University of Durham, Durham, United Kingdom

Background

The RCGP/NCAT National Audit of Cancer Diagnoses in Primary Care has multiple aims in the area of improving practice in early diagnosis. This abstract describes an aspect of this work: to identify delays in cancer patient pathways prior to diagnosis and any cancer types or patient subgroups that are particularly prone to delay.

Method

Practices from over half the English Cancer Networks participated in the audit, though not all collected data for the purpose of this quantitative analysis. While data collection is not yet complete we estimate that 4,000 GP will submit data on approximately 15,000 patients. Each practice recorded data describing demographics, diagnoses and pathway for cancer patients diagnosed in a 6-12 month period in 2009.

For each patient the following dates were recorded: occurrence of first symptoms; first presentation to primary care; referral to secondary care; and first contact with secondary care. The intervals allow patient delay, primary care delay, and secondary care delay to be calculated.

Results

A preliminary analysis was carried out on 3,159 patients from two network areas. Patient delay can be assessed in 72% of cases, primary care delay in 83%, and secondary care delay in 88% of cases. In this cohort, and where patient delay could be assessed, 83% is under 2 months, 11% between 2 and 6 months, and 6% over 6 months. Comparable figures for primary care delay are 90%, 8% and 2%. Of secondary care delays, 95% are under two months with 4% between 2 and 6 months and 1% over 6 months.

Stage at diagnosis across all tumour types is 45% organ confined, 27% local spread, 17% distant metastases, and 10% unknown.

Conclusion

The data quality and completeness of the data examined will be sufficient for robust conclusions to be drawn once the full dataset is collated and analysed.