Routes to Diagnosis, 2018

Earlier diagnosis of cancers remains key in reducing the number of patients diagnosed with late stage cancers, which improves cancer survival. The NHS Long Term Plan sets out a commitment to diagnose more cancers earlier, for example through lowering the threshold for GP referral and reviewing the cancer screening programmes.

The Routes to Diagnosis project links multiple health datasets to categorise the pathways that lead to a patient’s diagnosis of cancer. The 8 routes, covering all those diagnosed with cancer between 2006 and 2018, can be used to monitor system changes in cancer pathways and give an indication of the success of efforts to improve patient outcomes.

The project has over a decade of data that has shown positive changes in how people are diagnosed, most notably a reduction in emergency presentations, which have the lowest survival estimates. There has been an increase in Two Week Wait (TWW) referrals that reflects healthcare policy.

One of the aspects highlighted by Routes to Diagnosis is the inequality in how people are diagnosed. A study by Herbert and others found that age and deprivation affect the route to diagnosis. Older people continue to make up the bulk of those diagnosed as an emergency presentation, and those who are more deprived are also more likely to be diagnosed through this route. The NHS Long Term Plan highlights the need to tackle inequality, and the data provided by Routes to Diagnosis is one of the ways to measure the success of these ventures.