EDAG funded projects and outputs

This is a selection of outputs from Early Diagnosis Advisory Group funded projects.

EDAG funds policy relevant research or activities that are adding to the scientific evidence base to achieve earlier diagnosis and enable access to treatment.

Influence of doctor-patient conversations on behaviours of patients presenting to primary care with new or persistent symptoms: a video observation study.

Dorothee Amelung et al (2019) BMJ doi: 10.1136/bmjqs-2019-009485.

This work has built a model describing the different ways in which patient conversations with a GP can go wrong and what techniques can be used to ensure the consultation finishes with both parties in agreement. This evidence supports the production of CRUK’s healthcare professional facing resources and will be used to help ensure GP patient communications for cancer referrals are as effective as possible.

GPs’ understanding and practice of safety netting for potential cancer presentations: a qualitative study in primary care

Julie Evans et al (2018) BJGP https://doi.org/10.3399/bjgp18X696233

This study found GPs often developed their own safety netting methods learning from past mistakes. The personalised approach, pressure on GPs and caution not to create anxiety left lower risk patients with less robust safety netting. This reinforces our strategic aim to ensure appropriate management of cancers in primary care and has been used to support the development of safety netting resources for healthcare professionals.

Do colorectal cancer patients diagnosed as an emergency differ from non-emergency patients in their consultation patterns and symptoms? A longitudinal data-linkage study in England

Cristina Renzi et al (2016) British Journal of Cancer doi: 10.1038/bjc.2016.250.

This study found that patients diagnosed with colorectal cancer through emergency presentations in the UK have similar consultations histories as those diagnosed through non-emergency pathways. This shows that there may be opportunities to diagnose some of these patients earlier reinforcing our strategic aims to support colorectal recognition and referral in primary care.

For which cancers might patients benefit most from expedited symptomatic diagnosis?

Willie Hamilton et al (2015) BMC Cancer 15: 820. doi:10.1186/s12885-015-1865-x

The study found the highest ranking cancers, for which expedited diagnosis would most likely provide the greatest mortality benefit, were breast cancer, uterine cancer and melanoma, while brain and pancreatic cancers ranked lowest in terms of potential mortality benefit. These results could be used to help target development of interventions aiming to improve symptomatic diagnosis, to the highest ranking cancers. In contrast, research efforts for the lowest ranking cancers could be re-directed towards alternative avenues more likely to yield benefits, such as screening and treatment.  

Use of the English urgent referral pathway for suspected cancer and mortality in patients with cancer: cohort study.

Henrik Møller et al (2015) BMJ 351:h5102 doi: 10.1136/bmj.h5102

This study concluded that use of the urgent referral pathway could be efficacious.  Analysis of the mortality of more than 200,000 patients with cancer in England showed that the propensity of general practices to use the urgent referral pathway for suspected cancer was associated with the mortality outcome of their patients. General practices that consistently have a low propensity to use urgent referrals could consider increasing the use of this pathway to improve the survival of their cancer patients.