Background Patients with non-specific symptoms often experience longer times to diagnosis and poorer clinical outcomes than those with site-specific symptoms. This paper reports initial results from five multidisciplinary diagnostic centre (MDC) projects in England, piloting rapid referral for patients with non-specific symptoms. Methods The evaluation covered MDC activity from 1st December 2016 to 31st July 2018, with projects using a common dataset. Logistical regression analyses were conducted, with a diagnosis of any cancer as the dependent variable. Exploratory analysis was conducted on presenting symptoms and diagnoses of cancer, and on comparisons within these groupings. Results In total, 2961 patients were referred into the MDCs and 241 cancers were diagnosed. The pathway detected cancers across a broad range of tumour sites, including several rare and less common cancers. An association between patient age and cancer was identified (p < 0.001). GP 'clinical suspicion' was identified as a strong predictor of cancer (p = 0.006), with a reduced association with cancer observed in patients with higher numbers of GP consultation before referral (p = 0.008). Conclusions The MDC model diagnoses cancer in patients with non-specific symptoms, with a conversion rate of 8%, demonstrating the diagnostic potential of a non-site-specific symptomatic referral pathway.
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Univ Copenhagen, Ctr Gen Practice, Dept Publ Hlth, Copenhagen, Denmark
Res Unit Gen Practice Reg Zealand, Soro, DenmarkUniv Copenhagen, Ctr Gen Practice, Dept Publ Hlth, Copenhagen, Denmark
Damhus, Christina Sadolin
Brodersen, John Brandt
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Univ Copenhagen, Ctr Gen Practice, Dept Publ Hlth, Copenhagen, Denmark
Res Unit Gen Practice Reg Zealand, Soro, Denmark
Arctic Univ Norway, Dept Community Med, Gen Practice Res Unit, Fac Hlth Sci,UiT, Tromso, NorwayUniv Copenhagen, Ctr Gen Practice, Dept Publ Hlth, Copenhagen, Denmark
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Aarhus Univ, Res Unit Gen Practice, Res Ctr Canc Diag Primary Care CaP, Aarhus, Denmark
Silkeborg Reg Hosp, Univ Res Clin Innovat Patient Path, Ctr Diagnost, Silkeborg, DenmarkAarhus Univ, Res Unit Gen Practice, Res Ctr Canc Diag Primary Care CaP, Aarhus, Denmark
Naeser, Esben
Fredberg, Ulrich
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Silkeborg Reg Hosp, Univ Res Clin Innovat Patient Path, Ctr Diagnost, Silkeborg, DenmarkAarhus Univ, Res Unit Gen Practice, Res Ctr Canc Diag Primary Care CaP, Aarhus, Denmark
Fredberg, Ulrich
Moller, Henrik
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Aarhus Univ, Res Unit Gen Practice, Res Ctr Canc Diag Primary Care CaP, Aarhus, DenmarkAarhus Univ, Res Unit Gen Practice, Res Ctr Canc Diag Primary Care CaP, Aarhus, Denmark
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Bispebjerg & Frederiksberg Univ Hosp, Res Unit Clin Nursing, Copenhagen N, Denmark
Unit Evidence Based Nursing, Copenhagen N, DenmarkCopenhagen Univ Hosp, Dept Pulm & Infect Dis, Hillerod, Denmark