ArticleCancer epidemiology2020
Trends in time to cancer diagnosis around the period of changing national guidance on referral of symptomatic patients: A serial cross-sectional study using UK electronic healthcare records from 2006-17.
Article in Cancer epidemiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Outcomes of guidelines from health technology assessment organizations in community-based primary care: a systematic mixed studies review.International journal of technology assessment in health care · 2024Pooled it
- A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022Pooled it
- Time to diagnosis and treatment in younger adults with colorectal cancer: A systematic review.PloS one · 2022Pooled it
- Prediagnostic primary care consultations and imaging in emergency-diagnosed versus referred patients with lung cancer: a population-based linked data study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Assessing ethnic inequalities in diagnostic intervals of breast cancer among patients presenting symptoms to general practitioners in England.Scientific reports · 2026Article
- Is now the time to rethink risk thresholds in cancer referral guidelines?The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Unlocking cancer vaccine potential: What are the key factors?Human vaccines & immunotherapeutics · 2024Review
- Phenotypes and rates of cancer-relevant symptoms and tests in the year before cancer diagnosis in UK Biobank and CPRD Gold.PLOS digital health · 2023Article
- A taxonomy of early diagnosis research to guide study design and funding prioritisation.British journal of cancer · 2023Review
- Article
- Evaluation of treatment delays in hepatopancreatico-biliary surgery during the first COVID-19 wave.Annals of the Royal College of Surgeons of England · 2023Article
- Article
- Age and sex can predict cancer risk in people referred with breast symptoms.BMJ (Clinical research ed.) · 2023Article
- Reduction in COVID-19 related resource loss and decline in prevalence of probable depression in Chinese adults: an application of the Conservation of Resource Theory.Infectious diseases of poverty · 2023Article
- Diagnosing cancer earlier: what progress is being made?British journal of cancer · 2023Review
- The Effect of Older Age and Frailty on the Time to Diagnosis of Cancer: A Connected Bradford Electronic Health Records Study.Cancers · 2022Article
- Measurement of clinical delay intervals among younger adults with colorectal cancer using health administrative data: a population-based analysis.BMJ open gastroenterology · 2022Article
- 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
- Detecting ovarian cancer in primary care: can we do better?The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study.Cancers · 2022Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundUK primary-care referral guidance describes the signs, symptoms, and test results ("features") of undiagnosed cancer. Guidance revision in 2015 liberalised investigation by introducing more low-risk features. We studied adults with cancer whose features were in the 2005 guidance ("Old-NICE") or were introduced in the revision ("New-NICE"). We compared time to diagnosis between the groups, and its trend over 2006-2017.
methodsClinical Practice Research Datalink records were analysed for adults with incident myeloma, breast, bladder, colorectal, lung, oesophageal, ovarian, pancreatic, prostate, stomach or uterine cancers in 1/1/2006-31/12/2017. Cancer-specific features in the year before diagnosis were used to create New-NICE and Old-NICE groups. Diagnostic interval was time between the index feature and diagnosis. Semiparametric varying-coefficient analyses compared diagnostic intervals between New-NICE and Old-NICE groups over 1/1/2006-31/12/2017.
resultsOver all cancers (N = 83,935), median (interquartile range) Old-NICE diagnostic interval rose over 2006-2017, from 51 (20-132) to 64 (30-148) days, with increases in breast (15 vs 25 days), lung (103 vs 135 days), ovarian (65·5 vs 100 days), prostate (80 vs 93 days) and stomach (72·5 vs 102 days) cancers. Median New-NICE values were consistently longer (99, 40-212 in 2006 vs 103, 42-236 days in 2017) than Old-NICE values over all cancers. After guidance revision, New-NICE diagnostic intervals became shorter than Old-NICE values for colorectal cancer.
conclusionsDespite improvements for colorectal cancer, scope remains to reduce diagnostic intervals for most cancers. Liberalised investigation requires protecting and enhancing cancer-diagnostic services to avoid their becoming a rate-limiting step in the diagnostic pathway.
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