Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Dec 3;101 Suppl 2(Suppl 2):S87-91.
doi: 10.1038/sj.bjc.6605397.

Auditing the diagnosis of cancer in primary care: the experience in Scotland

P Baughan  1 , B O'Neill, E Fletcher
Affiliations

Auditing the diagnosis of cancer in primary care: the experience in Scotland

P Baughan et al. Br J Cancer. .

Abstract

Introduction: This paper reports on an ongoing primary care audit of cancer referrals undertaken in Scotland in 2006-2007 and 2007-2008.

Methods: General practitioners (GPs) in Scotland were asked to review all new cancer diagnoses within their practice during the preceding year.

Results: 4181 patients were identified in year 1 and 12 294 in year 2. The pathway taken for patients to present to, and be referred from, their GP has been analysed for 7430 of the 12 294 patients identified within year 2 across five separate health boards. The time from first symptoms to presentation to a GP varied between tumour types, being the longest (median 30 days) for head and neck cancers and the shortest (median 2 days) for bladder cancer. In all, 25% of patients within the following tumour groups waited longer than 2 months to present to their GP following first symptoms: prostate, colorectal, melanoma and head and neck cancers. Once patients had presented to their GP, those with prostate and lung cancer were referred later (median time 11 days) than those with breast cancer (median time 2 days). The priority with which GPs referred patients varied considerably between tumour groups (breast cancer 77.5% 'urgent' compared with prostate cancer 44.7% 'urgent'). In one health board the proportion of cancer patients being referred urgently increased from 46% to 58% between the first and second audit.

Conclusion: Our data show that there are very different patterns of presentation and referral for patients with cancer, with some tumour groups being more likely to be associated with a delayed diagnosis than others.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of cancers within analysis.
Figure 2
Figure 2
Median time from first noticing symptoms to first presentation with a GP.
Figure 3
Figure 3
Median time from first presentation to time of referral.
Figure 4
Figure 4
Priority of referral by tumour group for breast, colorectal, lung and prostate cancers.
Figure 5
Figure 5
Proportion of patients referred by priority group within one health board over 2 successive years.
Figure 6
Figure 6
Median time from referral sent to first seen by specialist.
See this image and copyright information in PMC

References

    1. Burgess C, Hunter MS, Ramirez AJ (2001) A qualitative study of delay among women reporting symptoms of breast cancer. Br J Gen Pract 51: 967–971 - PMC - PubMed
    1. Burgess C, Linsell L, Kapari M, Omar L, Mitchell M, Whelehan P, Richards MA, Ramirez AJ (2009) Promoting early presentation of breast cancer by older women: a preliminary evaluation of a one-to-one health professional-delivered intervention. J Psychosom Res 67: 377–385 - PubMed
    1. Chen Z, King W, Pearcey R, Kerba M, Mackillop WJ (2008) The relationship between waiting time for radiotherapy and clinical outcomes: a systematic review of the literature. Radiother Oncol 87: 3–16 - PubMed
    1. Hamilton W (2009) Five misconceptions in cancer diagnosis. Br J Gen Pract 59: 441–447 - PMC - PubMed
    1. Information Services Division. NHS National Services Division (2008) Cancer in Scotland. ISD: Edinburgh