The impact of the two-week wait rule on the diagnosis and management of bladder cancer in a single UK institution

Blick, Christopher; Bailey, David M.; Haldar, Neil A.; Bdesha, Amarjit; Kelleher, John; Muneer, Asıf

doi:10.1308/003588410x12518836440207

Cited by 20 publications

(24 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As can be seen in Table 4 [3,[9][10][11][12][13], the median delays reported in the present study are comparable to other series. Our present treatment delay compares particularly favourably, although this may simply reflect the fact that cystoscopy occurred at initial assessment in our series (and therefore waiting time to diagnostic cystoscopy did not contribute to treatment delay as it did in other series).…”

Section: Discussionsupporting

confidence: 89%

Delays in the diagnosis and initial treatment of bladder cancer in Western Australia

et al. 2017

View full text Add to dashboard Cite

Objectives To quantify and examine the causes of delays in the diagnosis and initial treatment of patients with bladder cancer in Western Australia. Subjects and Methods All attendances at a one‐stop haematuria clinic at a public tertiary‐level hospital in Western Australia between May 2008 and April 2014 were reviewed retrospectively. All patients diagnosed with a bladder tumour over this period were identified. These patients and their general practitioners were contacted retrospectively and invited to participate in telephone interviews, with additional data collected from clinical records as required. Waiting times to presentation, referral, assessment, and initial treatment were established for patients who presented with visible haematuria. Results Of 1 365 attendances, 151 patients were diagnosed with a bladder tumour and 100 of these were both suitable and agreed to participate in the study. For patients with visible haematuria the median (range) waiting time from initial bleeding to surgery was 69.5 (9–1 165) days. This was comprised of a median (range) pre‐referral waiting time of 12 (0–1 137) days, assessment waiting time of 23.5 (0–207) days, and treatment waiting time of 20 (1–69) days. Reasons for prolonged waiting times included poor public awareness, patient fear and anxiety, delayed and non‐referral from primary care, administrative delays, and resource limitations. Conclusion Many patients experience significant delays in the diagnosis and treatment of their bladder cancer in Western Australia, and this probably reflects national trends. These concerning data warrant consideration of how delays can be reduced to improve outcomes for these patients.

show abstract

Section: Discussionsupporting

confidence: 89%

Delays in the diagnosis and initial treatment of bladder cancer in Western Australia

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The main bias and applicability concerns related to the suboptimal identification and/or adjustment for confounders in 18 of the studies, 6 of which were studies using questionnaires,14–19 10 were retrospective cohort studies providing descriptive statistics mainly, using record reviews (n=5)20–24 and electronic health records (n=5),25–29 1 was a case–control study30 and 1 an ecological study 31…”

Section: Resultsmentioning

confidence: 99%

Quality of the diagnostic process in patients presenting with symptoms suggestive of bladder or kidney cancer: a systematic review

et al. 2019

View full text Add to dashboard Cite

ObjectivesIn urological cancers, sex disparity exists for survival, with women doing worse than men. Suboptimal evaluation of presenting symptoms may contribute.DesignWe performed a systematic review examining factors affecting the quality of the diagnostic process of patients presenting with symptoms of bladder or kidney cancer.Data sourcesWe searched Medline, Embase and the Cochrane Library from 1 January 2000 to 13 June 2019.Eligible criteriaWe focused on one of the six domains of quality of healthcare: timeliness, and examined the quality of the diagnostic process more broadly, by assessing whether guideline-concordant history, examination, tests and referrals were performed. Studies describing the factors that affect the timeliness or quality of the assessment of urinary tract infections, haematuria and lower urinary tract symptoms in the context of bladder or kidney cancer, were included.Data extraction and synthesisData extraction and quality assessment were independently performed by two authors. Due to the heterogeneity of study design and outcomes, the results could not be pooled. A narrative synthesis was performed.Results28 studies met review criteria, representing 583 636 people from 9 high-income countries. Studies were based in primary care (n=8), specialty care (n=12), or both (n=8). Up to two-thirds of patients with haematuria received no further evaluation in the 6 months after their initial visit. Urinary tract infections, nephrolithiasis and benign prostatic conditions before cancer diagnosis were associated with diagnostic delay. Women were more likely to experience diagnostic delay than men. Patients who first saw a urologist were less likely to experience delayed evaluation and cancer diagnosis.ConclusionsWomen, and patients with non-cancerous urological diagnoses just prior to their cancer diagnosis, were more likely to experience lower quality diagnostic processes. Risk prediction tools, and improving guideline ambiguity, may improve outcomes and reduce sex disparity in survival for these cancers.

show abstract

“…They examined patient cohorts at a single secondary care unit or geographically clustered GP practices (Barrett and Hamilton, 2005, 2008; Blick et al , 2010), or review such studies (Thorne et al , 2009). Overall, previous studies show variation in route to diagnosis by cancer type, but also consistently show a large fraction of cases not following routine, urgent or TWW GP Referral routes.…”

mentioning

confidence: 99%

Routes to diagnosis for cancer – determining the patient journey using multiple routine data sets

Elliss‐Brookes¹,

McPhail²,

Ives³

et al. 2012

Br J Cancer

452

493

View full text Add to dashboard Cite

Background:Cancer survival in England is lower than the European average, which has been at least partly attributed to later stage at diagnosis in English patients. There are substantial regional and demographic variations in cancer survival across England. The majority of patients are diagnosed following symptomatic or incidental presentation. This study defines a methodology by which the route the patient follows to the point of diagnosis can be categorised to examine demographic, organisational, service and personal reasons for delayed diagnosis.Methods:Administrative Hospital Episode Statistics data are linked with Cancer Waiting Times data, data from the cancer screening programmes and cancer registration data. Using these data sets, every case of cancer registered in England, which was diagnosed in 2006–2008, is categorised into one of eight ‘Routes to Diagnosis'.Results:Different cancer types show substantial differences between the proportion of cases that present by each route, in reasonable agreement with previous clinical studies. Patients presenting via Emergency routes have substantially lower 1-year relative survival.Conclusion:Linked cancer registration and administrative data can be used to robustly categorise the route to a cancer diagnosis for all patients. These categories can be used to enhance understanding of and explore possible reasons for delayed diagnosis.

show abstract

The impact of the two-week wait rule on the diagnosis and management of bladder cancer in a single UK institution

Cited by 20 publications

References 10 publications

Delays in the diagnosis and initial treatment of bladder cancer in Western Australia

Delays in the diagnosis and initial treatment of bladder cancer in Western Australia

Quality of the diagnostic process in patients presenting with symptoms suggestive of bladder or kidney cancer: a systematic review

Routes to diagnosis for cancer – determining the patient journey using multiple routine data sets

Contact Info

Product

Resources

About