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. 2019 Aug:61:111-118.
doi: 10.1016/j.canep.2019.05.010. Epub 2019 Jun 15.

Establishing population-based surveillance of diagnostic timeliness using linked cancer registry and administrative data for patients with colorectal and lung cancer

Clare Pearson  1 , Jess Fraser  2 , Michael Peake  3 , Roland Valori  4 , Veronique Poirier  5 , Victoria H Coupland  6 , Sara Hiom  5 , Sean McPhail  7 , Jodie Moffat  5 , Georgios Lyratzopoulos  7 , Jon Shelton  8
Affiliations

Establishing population-based surveillance of diagnostic timeliness using linked cancer registry and administrative data for patients with colorectal and lung cancer

Clare Pearson et al. Cancer Epidemiol. 2019 Aug.

Abstract

Background: Diagnostic timeliness in cancer patients is important for clinical outcomes and patient satisfaction but, to-date, continuous monitoring of diagnostic intervals in nationwide incident cohorts has been impossible in England.

Methods: We developed a new methodology for measuring the secondary care diagnostic interval (SCDI - first relevant secondary care contact to diagnosis) using linked cancer registration and healthcare utilisation data. Using this method, we subsequently examined diagnostic timeliness in colorectal and lung cancer patients (2014-15) by socio-demographic characteristics, diagnostic route and stage at diagnosis.

Results: The approach assigned SCDIs to 94.4% of all incident colorectal cancer cases [median length (90th centile) of 25 (104) days] and 95.3% of lung cancer cases [36 (144) days]. Advanced stage patients had shorter intervals (median, colorectal: stage 1 vs 4 - 34 vs 19 days; lung stage 1&2 vs 3B&4 - 70 vs 27 days). Routinely referred patients had the longest (colorectal: 61, lung: 69 days) and emergency presenters the shortest intervals (colorectal: 3, lung: 14 days). Comorbidities and additional diagnostic tests were also associated with longer intervals.

Conclusion: This new method can enable repeatable nationwide measurement of cancer diagnostic timeliness in England and identifies actionable variation to inform early diagnosis interventions and target future research.

Keywords: Colorectal cancer; Diagnostic intervals; Early detection of cancer; Early diagnosis; England; Lung cancer; Population-based cancer registries; Secondary care.

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Figures

Fig. 1
Fig. 1
Flow diagram to show the exclusions applied to the cohorts.
Fig. 2
Fig. 2
Calculation of the SCDI.
Fig. 3
Fig. 3
Secondary care diagnostic interval (SCDI) by diagnostic route and stage, Colorectal cancer.
Fig. 4
Fig. 4
Secondary care diagnostic interval (SCDI) by diagnostic route and stage, Lung cancer.
See this image and copyright information in PMC

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