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Conclusions Implementation of the VAS pathway in Croydon demonstrated a 4% cancer conversion rate and a 29% conversion rate for clinically significant benign pathology although it did not reduce time to diagnosis.Integration of a VAS pathway in existing clinical services should be considered for diagnosis of benign but relevant symptomatic conditions.A VAS pathway could potentially assist GPs in referring patients early which should translate into early diagnosis of cancers not necessarily confined only to the gastrointestinal tract although more data is required to support this.