RT Journal Article
SR Electronic
T1 Cancer detection via primary care urgent referral in England 2009/10 to 2018/19 and the association with practice characteristics
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP BJGP.2020.1030
DO 10.3399/BJGP.2020.1030
A1 Thomas Round
A1 Mark Ashworth
A1 Veline L'Esperance
A1 Henrik Møller
YR 2021
UL http://bjgp.org/content/early/2021/06/25/BJGP.2020.1030.abstract
AB Background: There is substantial variation in use of urgent suspected cancer referral (two week wait/2WW) between practices. Aim: To examine change in use of 2WW referrals in England over ten years (2009/10 to 2018/19) and practice and population factors associated with cancer detection. Design and Setting: Retrospective cross-sectional study of English general practices and their 2WW referral and cancer waiting times (CWT) detection data (all cancers other than non melanoma skin cancers) 2009/10 to 2018/19. Methods: Descriptive statistics of changes over ten years in 2WW referral data. Yearly linear regression models to determine the association between cancer detection rates and quintiles of practice and population characteristics. Predicted cancer detection rates were calculated and the difference between lowest (Q1) to highest (Q5) quintiles. Results: Over the ten years studied there were 14.89m 2WW referrals (2.2m 2018/19), 2.68m new cancer diagnoses of which 1.26m were detected following 2WW. The detection rate increased from 41% to 52%. In 2018/19 an additional 66,172 cancers were detected via 2WW compared to 2009/10. Higher cancer detection via 2WW referrals was associated with larger practices and those with younger GPs. From 2016/17 onwards more deprived practice populations were associated with decreased cancer detection. Conclusions: From 2009/10 to 2018/19 2WW referrals increased on average by 10% year on year. Higher cancer detection was found in larger practices, with relatively younger GPs and more recently, less deprived populations. COVID-19 has led to significant impacts on 2WW referral activity and the impact on patient outcomes will need to be studied.