The relative length of the patient and the primary care interval in patients with 28 common and rarer cancers.
BACKGROUND
Appreciating variation in the length of pre- or post-presentation diagnostic intervals can help prioritise early diagnosis interventions with either a community or a primary care focus.


METHODS
We analysed data from the first English National Audit of Cancer Diagnosis in Primary Care on 10 953 patients with any of 28 cancers. We calculated summary statistics for the length of the patient and the primary care interval and their ratio, by cancer site.


RESULTS
Interval lengths varied greatly by cancer. Laryngeal and oropharyngeal cancers had the longest median patient intervals, whereas renal and bladder cancer had the shortest (34.5 and 30 compared with 3 and 2 days, respectively). Multiple myeloma and gallbladder cancer had the longest median primary care intervals, and melanoma and breast cancer had the shortest (20.5 and 20 compared with 0 and 0 days, respectively). Mean patient intervals were longer than primary care intervals for most (18 of 28) cancers, and notably so (two- to five-fold greater) for 10 cancers (breast, melanoma, testicular, vulval, cervical, endometrial, oropharyngeal, laryngeal, ovarian and thyroid).


CONCLUSIONS
The findings support the continuing development and evaluation of public health interventions aimed at shortening patient intervals, particularly for cancers with long patient interval and/or high patient interval over primary care interval ratio.
1] Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK [2] Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.
G
G
Lyratzopoulos
Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.
C L
CL
Saunders
Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.
G A
GA
Abel
National Cancer Intelligence Network (NCIN), Public Health England, 5th Floor, Wellington House, 135-155 Waterloo Road, London SE1 8UG, UK.
S
S
McPhail
North Wales Centre for Primary Care Research, College of Health and Behavioural Sciences, Bangor University, Gwenfro Unit 5, Wrexham Technology Park, Wrexham LL13 7YP, UK.
R D
RD
Neal
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
J
J
Wardle
Wolfson Research Institute, School of Medicine and Health, University of Durham, Queen's Campus, University Boulevard, Stockton-on-Tees TS17 6BH, UK.
G P
GP
Rubin
D000293:Adolescent; D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D057210:Delayed Diagnosis; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000628:therapy; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D035583:Rare Diseases / Q000175:diagnosis* / Q000628:therapy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult