Diagnosing cancer in patients with 'non-alarm' symptoms: Learning from diagnostic care innovations in Denmark.

Abstract

Efforts to improve cancer outcomes have led to the introduction of policies to enable ‘fast-track’ referrals from primary to secondary care for patients with possible cancer. Although these schemes, also known as ‘two-week-wait’ referrals, have been successful in shortening diagnostic intervals [1,2], their usefulness is limited to patients who present with ‘alarm’ symptoms of relatively high predictive value for neoplastic disease [1,3]. In contrast, achieving a prompt diagnostic resolution in the approximate half of all cancer patients who initially present with non-specific and lower risk symptoms remains a challenge [1,2]. To address this problem, hospital-based multi-disciplinary diagnostic services have been recently introduced in Denmark and England for patients with non-specific symptoms [4,5]. Two Danish studies published recently in this Journal add substantially to relevant emerging evidence [6,7].