Timely diagnosis of cancer is important for the best clinical outcomes and patient experience. Existing evidence shows that there are large differences in how quickly a diagnosis is made by cancer type, as well as by patient age, gender, ethnicity and socioeconomic status. To improve clinical outcomes as well as patient experience, it is important to understand why certain patient groups experience a longer time to diagnosis, and study what happens after they first see their family doctor and before a diagnosis is reached. This study examines the consultations, investigations, referral and relevant treatment patterns in primary and specialist care leading up to a cancer diagnosis in patients with a range of common cancers, in order to determine factors associated with a longer time to diagnosis. The findings will form the basis for developing interventions aiming to improve the timely diagnosis of cancer.
Timely diagnosis is important for clinical outcomes including survival, patient experience and health system efficiency. While we know that variations in biological, patient and healthcare factors may contribute to a later diagnosis when treatment with curative intent is not possible, relatively little is known about how they do so and the responsible mechanisms that may be amenable to interventions. Examining patterns of variation in healthcare events and treatments before a diagnosis is made can highlight inequalities in current clinical practice that may represent missed diagnostic opportunities. We will first study patterns of pre-diagnostic events including symptoms, primary and related specialist tests, referrals and primary care prescriptions for a range of common cancers. Using quantile regression, we will then examine how pre-diagnostic events are associated with the total healthcare (time of first presentation with a relevant symptom to diagnosis) and primary care (time from first presentation to referral) intervals. Our findings will inform the development of targeted interventions aimed to improve timely diagnosis of cancer.
Health care diagnostic interval (from time of presentation to diagnosis); Primary care interval (from time of presentation to referral).
Yin Zhou - Chief Investigator - University of Cambridge
Yin Zhou - Corresponding Applicant - University of Cambridge
Catherine Saunders - Collaborator - University of Cambridge
Efthalia (Lina) Massou - Collaborator - University of Cambridge
Fiona Walter - Collaborator - University of Cambridge
Frank Corvino - Collaborator - Genesis Research LLC
Garth Funston - Collaborator - University of Cambridge
Georgios Lyratzopoulos - Collaborator - University College London ( UCL )
Hannah Higgins - Collaborator - University of Cambridge
Kirsten Arendse - Collaborator - University of Cambridge
Marie Moullet - Collaborator - University of Cambridge
Marije van Melle - Collaborator - University of Cambridge
Sam Merriel - Collaborator - University of Exeter
Silvia (Silva) Mendonca - Collaborator - University of Cambridge
HES Admitted Patient Care;HES Diagnostic Imaging Dataset;NCRAS Cancer Registration Data;Patient Level Index of Multiple Deprivation