First results from five multidisciplinary diagnostic centre (MDC) projects for non-specific but concerning symptoms, possibly indicative of cancer
-
Published:2020-07-06
Issue:5
Volume:123
Page:722-729
-
ISSN:0007-0920
-
Container-title:British Journal of Cancer
-
language:en
-
Short-container-title:Br J Cancer
Author:
Chapman D.ORCID, Poirier V.ORCID, Vulkan D.ORCID, Fitzgerald K.ORCID, Rubin G.ORCID, Hamilton W.ORCID, Duffy S. W.ORCID, Thomas Alan Hart, Gulliford Dawn, Rolfe Helena, Hohmann Matthias, Repperday Chris, Sykes Susan, Taylor Sarah, Craig Angie, Dawson James, Forbes Sarah, Ryan Helen, Turner Rob, Ahmad Mush, Chung Donna, Graham David, Millar Andrew, Taiyari Sara, Smith Claire Friedemann, Gleeson Fergus, Hayles Shelley, Kaveney Zoe, Nicholson Brian, , , , , , , , , , ,
Abstract
Abstract
Background
Patients with non-specific symptoms often experience longer times to diagnosis and poorer clinical outcomes than those with site-specific symptoms. This paper reports initial results from five multidisciplinary diagnostic centre (MDC) projects in England, piloting rapid referral for patients with non-specific symptoms.
Methods
The evaluation covered MDC activity from 1st December 2016 to 31st July 2018, with projects using a common dataset. Logistical regression analyses were conducted, with a diagnosis of any cancer as the dependent variable. Exploratory analysis was conducted on presenting symptoms and diagnoses of cancer, and on comparisons within these groupings.
Results
In total, 2961 patients were referred into the MDCs and 241 cancers were diagnosed. The pathway detected cancers across a broad range of tumour sites, including several rare and less common cancers. An association between patient age and cancer was identified (p < 0.001). GP ‘clinical suspicion’ was identified as a strong predictor of cancer (p = 0.006), with a reduced association with cancer observed in patients with higher numbers of GP consultation before referral (p = 0.008).
Conclusions
The MDC model diagnoses cancer in patients with non-specific symptoms, with a conversion rate of 8%, demonstrating the diagnostic potential of a non-site-specific symptomatic referral pathway.
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Oncology
Reference33 articles.
1. Neal, R., Din, N., Hamilton, W., Ukoumunne, O., Carter, B., Stapley, S. et al. Comparison of cancer diagnostic intervals before and after implementation of NICE guidelines: analysis of data from the UK General Practice Research Database. Br. J. Cancer 110, 584 (2014). 2. National Institute for Health and Care Excellence. Suspected cancer: recognition and referral. NICE guideline (NG12, 2015). 3. Koo, M. M., Hamilton, W., Walter, F. M., Rubin, G. P. & Lyratzopoulos, G. Symptom Signatures and Diagnostic Timeliness in Cancer Patients: A Review of Current Evidence. Neoplasia, Feb 20, 165–174 (2018). 4. Jørgensen, S. F., Ravn, P., Thorsen, S. & Worm, S. W. Characteristics and outcomes in patients with non-specific symptoms and signs of cancer referred to a fast track cancer patient pathway; a retrospective cohort study. BMC Cancer 17, 809 (2017) 5. Nicholson, B., Hamilton, W., O’Sullivan, J., Aveyard, P. & Hobbs, R. Weight loss as a predictor of cancer in primary care: a systematic review and meta-analysis. Br. J. Gen. Pract. 68, e311–e322 (2018).
Cited by
36 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|