Urgent referrals for suspected cancer in England 2009/10-2019/20: temporal trend analysis of population-based routine data

Project Summary

In England and Wales, an urgent referral pathway for patients presenting to GPs with symptoms suggestive of cancer was introduced in 2000, whereby all patients should be seen by a specialist within two weeks of referral (as known as the Two Week Wait (TWW) pathway). Over the last decade the number of patients referred via this pathway has more than doubled with around 2.4 million referrals in 2019/20. In addition to monitoring TWW referral rates, other key indicators used to monitor the referral process are the conversion rate, which is the percentage of TWW referrals resulting in a cancer diagnosis, and the detection rate, which is the percentage of new cancer cases starting treatment as a result of a TWW referral. These metrics are now available reported by cancer pathway.

In this study we will describe and quantify changes in TWW referral, conversion and detection rates for England over the last decade across the twelve different cancer pathways. We will hypothesis potential reasons for the changes observed within each pathway.  This research is important to inform future policy and research and to fully understand the impact of increasing referrals on conversion and detection rates, as well as the wider impact on patients and the health system.

Publications

• Smith S, Sansom N, Hemphill S, Bradley SH, Shinkins B, Wheatstone P, Hamilton W, Neal RD. Trends and variation in urgent referrals for suspected cancer 2009/2010–2019/2020,
  British Journal of General Practice 2022; 72 (714): 34-37. doi: 10.3399/bjgp22X718217