Article Text
Abstract
Introduction Cancer survival in England lags behind most European countries, due partly to lower rates of early stage diagnosis. We report the protocol for the evaluation of a multidisciplinary diagnostic centre-based pathway for the investigation of ‘low-risk but not no-risk’ cancer symptoms called the Suspected CANcer (SCAN) pathway. SCAN is a new standard of care being implemented in Oxfordshire; one of a number of pathways implemented during the second wave of the Accelerate, Coordinate, Evaluate (ACE) programme, an initiative which aims to improve England’s cancer survival rates through establishing effective routes to early diagnosis.
Methods and analysis To evaluate SCAN, we are collating a prospective database of patients referred onto the pathway by their general practitioner (GP). Patients aged over 40 years, with non-specific symptoms such as weight loss or fatigue, who do not meet urgent cancer referral criteria or for whom symptom causation remains unclear after investigation via other existing pathways, can be referred to SCAN. SCAN provides rapid CT scanning, laboratory testing and clinic review within 2 weeks. We will follow all patients in the primary and secondary care record for at least 2 years. The data will be used to understand the diagnostic yield of the SCAN pathway in the short term (28 days) and the long term (2 years). Routinely collected primary and secondary care data from patients not referred to SCAN but with similar symptoms will also be used to evaluate SCAN. We will map the routes to diagnosis for patients referred to SCAN to assess cost-effectiveness. Acceptability will be evaluated using patient and GP surveys.
Ethics and dissemination The Oxford Joint Research Office Study Classification Group has judged this to be a service evaluation and so outside of research governance. The results of this project will be disseminated by peer-reviewed publication and presentation at conferences.
- organisation of health services
- adult oncology
- oncology
- primary care
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Contributors FG, SH, SA, BDN, TM, ZK and DL designed the clinical pathway. BDN, JO and LA designed this pathway evaluation. BDN developed the patient information leaflet. JL, J-AP, JO and SH reviewed the patient information leaflet. BDN, CFS, IG and SK designed and oversaw the building of the SCAN database. BDN, CFS and ZK designed and set up the procedures for the audit of clinical records for comparator data. BDN, JO and CFS wrote this protocol. All authors reviewed and gave comments, will be involved in the running of this evaluation study and the analysis of the results and have read and approved this protocol.
Funding This work is supported by Cancer Research UK, Macmillan Cancer Support, NHS England and the Department of Health’s Policy Research Units. As part of the ACE programme, CRUK put out a search brief and specified some areas on which the pathways should be evaluated.
Competing interests None declared.
Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Provenance and peer review Not commissioned; externally peer reviewed.
Collaborators The authors would like to thank Shahista Hussain from OUHFT Research and Development who assisted with the development of the patient information leaflet.