The impact of rurality on patient experience and diagnostic pathway intervals in Scotland’s cancer patients: Further results from a national cancer diagnosis audit

Maxwell, Susanne; Pearce, C; Anderson, Lesley A.; Weller, David; Murchie, Peter

doi:10.1016/j.canep.2023.102414

Cited by 2 publications

(1 citation statement)

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“…Overall, there is the possibility that participating practices difered in important respects with those that did not participate, but the need to assure practice anonymity prevents us from exploring this point in detail. Whilst there was no diference in the age, cancer type, number of comorbidities, and stage at diagnosis between the two audit cohorts, there were signifcant diferences in the SIMD and urban/rural mix and we have published a separate paper exploring the observed infuence of socioeconomic status and place of residence on diagnostic pathways in the combined audits [41]. We have thus focussed on any substantive diferences between the two cohorts in their referral type, primary care, and diagnostic interval.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Revisiting Cancer Diagnosis in Scotland: Further Insights from the Second Scottish National Cancer Diagnosis Audit

Maxwell,

Kynn,

Weller

et al. 2024

European Journal of Cancer Care

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Objective. To characterise cancer diagnosis in Scottish primary care in 2018/19 and draw comparisons with diagnostic activity in 2014. Methods. A national audit of cancer diagnosis undertaken in Scottish general practices. Participating GPs collected diagnostic pathway data on patients diagnosed with cancer in 2018/19 from medical records. These data were supplemented by linkage to the Scottish Cancer Registry and previous audit data from 2014. Analyses explored and compared patient demographics, presentation, diagnostic routes, and intervals. Results. Seventy-three practices submitted data on 2,014 cases in 2014 and 90 practices submitted data on 2,318 cases in 2018/2019. Individual demographics and types of cancer were similar. There was a higher proportion of USC (urgent suspected cancer) referrals in 2019 than 2014 (42.9% vs 38.1%, p=0.008) but a similar proportion of emergency presentations (19.2% vs 20.4%). Primary care (median 4 (IQR 0–22) vs 5 (0–23)) and diagnostic intervals (27 (10–59) vs 30 (13–68)) were similar in both periods. Significantly fewer (24.5% vs 28.3, p=0.015) had a diagnostic interval >60 days in 2019 than 2014. Harder to diagnose cancers were more likely to present as emergencies and be subject to prolonged delays in both cohorts. Conclusions. The 2014 and 2018/19 cohorts were broadly similar. There is limited evidence that USC use had increased between 2014 and 2018/19. Harder to diagnose cancers are still most likely to present as emergencies and be subject to delays. Overall, it seems there were small improvements in cancer diagnosis prepandemic and a further audit could examine evidence for a postpandemic recovery.

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Section: Strengths and Limitationsmentioning

confidence: 99%