In partnership with Public Health England, we calculated secondary care diagnostic intervals for the first time for colorectal and lung cancer patients (diagnosed in 2014 and 2015). We explored how these intervals varied by socio-demographic factors, route to diagnosis, and stage at diagnosis.
Understanding the secondary care diagnostic interval (SCDI) offers a benchmark for how long patients wait for a diagnosis after entering secondary care.
It indicates where and how much improvement is needed to ensure patient diagnostic pathways are as rapid as possible to optimise patient experience and potentially improve outcomes.
You can explore the data in more detail using the online diagnostic intervals tool, which shows variation by cancer site and cancer alliance Visit the online tool.
For further insights, see:
Public health Matters blog Seven things we learnt by measuring the length of cancer diagnostic pathways – UK Health Security Agency.
CRUK news blog - The first complete picture of how long it takes to diagnose cancer in England.
SCDIs varied significantly by stage of disease, route to diagnosis and comorbidity score.
Shorter SCDIs were seen in patients diagnosed via emergency presentation or the Two Week Wait pathway, across all stages of disease.
Longer SCDIs were associated with early-stage disease, routine GP referrals, outpatient diagnostic routes, and in patients with more comorbidities or who require additional diagnostic investigations
A quarter of patients diagnosed via the Two Week Wait pathway had intervals longer than 38 days (colorectal) and 63 days (lung). This may reflect waiting for specialist tests, suboptimal test selection, incomplete or inadequate tests (which may need to be repeated), or alternative tests. Older and less fit patients may also experience longer than average intervals when preparation is needed for invasive investigations such as colonoscopy.
While comparisons between cancer sites are difficult due to differences in diagnostic procedures and symptom development, we found that:
For colorectal cancer, females were more likely to experience longer SCDIs. This pattern was not seen in lung cancer.
For lung cancer, longer SCDIs are partly due to diagnostics (particularly chest Xray) which can be requested in primary care (while colorectal cancer diagnostics typically happen in secondary care).
Shorter diagnostic intervals support timely diagnosis and treatment and improve patient the experience of the health service.
The method is scalable to other cancer sites and can be used to monitor diagnostic timeliness nationwide, and to identify areas for improvement to support earlier diagnosis.
Read the journal in fullClare Pearson, Jess Fraser, Michael Peake, Roland Valori, Veronique Poirier, Victoria H. Coupland, Sara Hiom, Sean McPhail, Jodie Moffat, Georgios Lyratzopoulos, Jon Shelton.
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