Delays in the diagnosis of six cancers: analysis of data from the National Survey of NHS Patients: Cancer

Abstract

The aim of this paper is to describe and compare components of diagnostic delay (patient, primary care, referral, secondary care) for six cancers (breast, colorectal, lung, ovarian, prostate and non-Hodgkin's lymphoma), and to compare delays in patients who saw their GP prior to diagnosis with those who did not. Secondary data analysis of The National Survey of NHS Patients: Cancer was undertaken (65 192 patients). Breast cancer patients experienced the shortest total delays (mean 55.2 days), followed by lung (88.5), ovarian (90.3), non-Hodgkin's lymphoma (102.8), colorectal (125.7) and prostate (148.5). Trends were similar for all components of delay. Compared with patient and primary care delays, referral delays and secondary care delays were much shorter. Patients who saw their GP prior to diagnosis experienced considerably longer total diagnostic delays than those who did not. There were significant differences in all components of delay between the six cancers. Reducing diagnostic delays with the intention of increasing the proportion of early stage cancers may improve cancer survival in the UK, which is poorer than most other European countries. Interventions aimed at reducing patient and primary care delays need to be developed and their effect on diagnostic stage and psychological distress evaluated.

Figures

Figure 1

Individual components of delay in diagnosis.

Figure 2

Total diagnostic delay (GP vs non-GP).

Figure 3

Total prehospital delay (patient, primary care and referral delay for GP patients and patient delay for non-GP patients).

Figure 4

Patient and primary care delay.

Figure 5

Referral delay.

Figure 6

Secondary care delay.

Figure 7

Secondary care delay by GP contact.