Improvement in cancer diagnosis times, following NICE guidance
Bowel, oesophageal and pancreatic cancers have seen the greatest improvement in the time it takes from when a patient first visits their GP with symptoms to when they are diagnosed with the disease, research suggests.
The latest findings, presented at the National Cancer Research Institute (NCRI) Cancer Conference in Liverpool, highlight the positive impact that the NICE referral guideline for suspected cancer has had since its launch in 2005.
Researchers collected data on more than 14,400, patients aged 40 and over, with breast, bowel, lung, pancreatic, oesophageal and stomach cancers in 2001/2 and then in 2007/8, using the General Practice Research Database.
The NICE referral guidance was published midway between the two time periods and provides GPs with details of “red flag” symptoms that should prompt them to send a patient for further tests.
Prior to the guidance, bowel (colon and rectal) cancer was on average diagnosed 96 days after patients first reported a symptom to a GP to when they were diagnosed. This dropped significantly to 75 days in 2007-8.
For oesophageal cancer in 2001/2 the average time to diagnosis after first GP visit was 59 days. This fell to 48 days in 2007-8.
Diagnosis time for pancreatic cancer fell from 63 to 52 days over the same time period.
Breast, stomach and lung cancers also showed a drop, though not a significant one according to the researchers.
Lead researcher Dr Richard Neal, from the North Wales Centre for Primary Care Research at Bangor University, said: “We found that diagnostic intervals can and do change over time. The reduction between 2001-2 and 2007-8 may in part be due to the roll out of the 2005 NICE referral guidance for suspected cancer.
“This gives clear guidance on which symptoms should prompt a doctor to refer a patient for further investigation. But there is considerable variation between cancers, with diagnostic intervals highest in those cancers which are more difficult to diagnose.
“Diagnostic intervals were longer for patients with harder to diagnose cancers and for those presenting with symptoms that did not qualify for an urgent referral.
“But diagnostic intervals remain long in most cancers, with considerable potential for further reduction. In particular, the diagnostic intervals for the 10 per cent of patients who are diagnosed most slowly remain very long for most cancers. And we do not fully know the effect of the reduction of diagnostic intervals on improvements in stage at diagnosis and long term survival.”
Sara Hiom, Cancer Research UK's director of information, added: “It's very encouraging to see that patients are, on average, being diagnosed more quickly for some cancers, offering a better chance of successful outcome.
“It's clearly vital for GPs to have access to good quality information to make the best decisions for their patients. There is still room for considerable improvement though, and reducing the time to diagnose and treat is a critical part of improving outcomes for people with cancer.”
8 November 2011