National Cancer Diagnosis Audits for England 2018 versus 2014: a comparative analysis.

Area of Science:

• Oncology
• Primary Care Medicine
• Health Services Research

Background:

• Timely cancer diagnosis in primary care is a critical quality improvement priority.
• National Institute for Health and Care Excellence (NICE) guidelines aim to improve suspected cancer referral processes.

Purpose of the Study:

• To evaluate changes in the cancer diagnostic process and its timeliness.
• To compare diagnostic pathways before and after the 2015 NICE guidance publication.

Main Methods:

• Population-based clinical audits of cancer diagnosis in English general practices (2014 and 2018).
• Comparison of patient characteristics, pre-referral consultations, investigations, and referral types.
• Descriptive analysis and regression models used for comparison.

Main Results:

• Increased same-day referrals (42.7% in 2018 vs. 37.7% in 2014) and reduced median diagnostic intervals.
• Fewer pre-referral consultations (18.8% vs. 26.2%) and decreased emergency referrals (13.4% vs. 16.5%) in 2018.
• Increased use of primary care investigations (47.9% vs. 45.4%) and urgent referrals (54.8% vs. 51.8%).

Conclusions:

• Substantial improvements in the cancer diagnostic process were noted between 2014 and 2018.
• These improvements align with the period following the 2015 national guideline update.
• The study highlights positive changes in cancer diagnosis pathways within primary care.