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The relative length of the patient and the primary care interval in patients with 28 common and rarer cancers.

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Lyratzopoulos, Georgios  ORCID logo
Saunders, CL 
Abel, GA 
McPhail, S 
Neal, RD 


BACKGROUND: Appreciating variation in the length of pre- or post-presentation diagnostic intervals can help prioritise early diagnosis interventions with either a community or a primary care focus. METHODS: We analysed data from the first English National Audit of Cancer Diagnosis in Primary Care on 10 953 patients with any of 28 cancers. We calculated summary statistics for the length of the patient and the primary care interval and their ratio, by cancer site. RESULTS: Interval lengths varied greatly by cancer. Laryngeal and oropharyngeal cancers had the longest median patient intervals, whereas renal and bladder cancer had the shortest (34.5 and 30 compared with 3 and 2 days, respectively). Multiple myeloma and gallbladder cancer had the longest median primary care intervals, and melanoma and breast cancer had the shortest (20.5 and 20 compared with 0 and 0 days, respectively). Mean patient intervals were longer than primary care intervals for most (18 of 28) cancers, and notably so (two- to five-fold greater) for 10 cancers (breast, melanoma, testicular, vulval, cervical, endometrial, oropharyngeal, laryngeal, ovarian and thyroid). CONCLUSIONS: The findings support the continuing development and evaluation of public health interventions aimed at shortening patient intervals, particularly for cancers with long patient interval and/or high patient interval over primary care interval ratio.



Adolescent, Adult, Aged, Appointments and Schedules, Delayed Diagnosis, Early Detection of Cancer, Female, Humans, Male, Middle Aged, Neoplasms, Patient Acceptance of Health Care, Primary Health Care, Rare Diseases, Referral and Consultation, Time Factors, Young Adult

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Br J Cancer

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Springer Science and Business Media LLC
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We are grateful to all primary care professionals in participating practices for collecting, collating and submitting anonymous data to the National Audit of Cancer Diagnosis in Primary Care and to participating (former) Cancer Networks, the Royal College of General Practitioners, the (former) Department of Health National Cancer Action Team and the National Clinical Intelligence Network of Public Health England for supporting the audit. The work is an independent research supported by different funding schemes. GL is supported by a post-doctoral fellowship by the National Institute for Health Research (PDF-2011-04-047) to end of 2014 and a Cancer Research UK Clinician Scientist Fellowship award (A18180) from 2015. RDN receives funding from Public Health Wales and Betsi Cadwaladr University Health Board. JW is supported by Cancer Research UK (C1418/A14134).