ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2012
Variation in use of the 2-week referral pathway for suspected cancer: a cross-sectional analysis.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 4 of them syntheses that pooled it.
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52 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- Direct access cancer testing in primary care: a systematic review of use and clinical outcomes.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Pooled it
- Pooled it
- Trial
- A geographical cluster randomised stepped wedge study of continuing medical education and cancer diagnosis in general practice.Implementation science : IS · 2014Trial
- Empowering patients? The role of self-referral in early cancer detection.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Inclusion in the cancer patient pathway among cancer patients with and without pre-existing mental or substance use disorders: a nationwide register-based study.BMC public health · 2025Article
- GP referrals for suspected cancer in Ireland: protocol for a cross-sectional study (GRACCHUS).HRB open research · 2025Article
- Clinical decision making and risk appraisal using electronic risk assessment tools for cancer diagnosis: a qualitative study of GP experiences.BJGP open · 2025Article
- How GPs communicate the urgent suspected cancer referral pathway to patients: a qualitative study of GP-patient consultations.BJGP open · 2025Article
- Diagnostic process of cancer in a health system without gatekeeping: a single centre survey analysis.Primary health care research & development · 2024Article
- Effect of cancer waiting time standards in the English National Health Service: a threshold analysis.BMC health services research · 2024Article
- Time intervals in the care pathway to cancer diagnosis during the COVID-19 pandemic: A large retrospective study from a high-volume center.International journal of cancer · 2023Article
- Concordance with urgent referral guidelines in patients presenting with any of six 'alarm' features of possible cancer: a retrospective cohort study using linked primary care records.BMJ quality & safety · 2022Article
- Using cancer risk algorithms to improve risk estimates and referral decisions.Communications medicine · 2022Article
- Article
- Protocol for a feasibility study incorporating a randomised pilot trial with an embedded process evaluation and feasibility economic analysis of ThinkCancer!: a primary care intervention to expedite cancer diagnosis in Wales.Pilot and feasibility studies · 2021Article
- The effectiveness of the Guy's Rapid Diagnostic Clinic (RDC) in detecting cancer and serious conditions in vague symptom patients.British journal of cancer · 2021Article
- COVID-19 and Oncology: Service transformation during pandemic.Cancer medicine · 2020Article
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA 2-Week Wait (2WW) referral pathway for earlier diagnosis of suspected cancer was introduced in England in 2000. Nevertheless, a significant proportion of patients with cancer are diagnosed by other routes (detection rate), only a small proportion of 2WW referrals have cancer (conversion rate) and there is considerable between-practice variation.
aimThis study examined use by practices of the 2WW referral in relation to all cancer diagnoses. DESIGN AND
settingA cross-sectional analysis of data extracted from the Cancer Waiting Times Database for all 2WW referrals in 2009 and for all patients receiving a first definitive treatment in the same year.
methodThe age standardised referral ratio, conversion rate, and detection rate were calculated for all practices in England and the correlation coefficient for each pair of measures. The median detection rate was calculated for each decile of practices ranked by conversion rate and vice versa, performing nonparametric tests for trend in each case.
resultsData for 8049 practices, 865 494 referrals, and 224 984 cancers were analysed. There were significant correlations between referral ratio and conversion rate (inverse) and detection rate (direct). There was also a direct correlation between conversion and detection rates. There was a significant trend in conversion rate for deciles of detection rate, and vice versa, with a marked difference between the lowest and higher deciles.
conclusionThere is a consistent relationship between 2WW referral conversion rate and detection rate that can be interpreted as representing quality of clinical practice. The 2WW referral rate should not be a measure of quality of clinical care.
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