Interventions to encourage early diagnosis of future cancer after a negative urgent referral

Start Date Jun 2021

Code K1-Aff

Status Ongoing

Project Lead
Senior Lead
King's College London
Dr Brian Nicholson (University of Oxford), Dr Tom Round, Dr Jo Waller (both King’s), Carolynn Gildea (National Cancer Registration and Analysis Service), Debra Smith (PPI representative)

Project summary

When patients visit their doctor with symptoms that could be due to cancer, they may be referred to be seen by a specialist or have a test within two weeks. More than 90% of those referred on this two-week wait (TWW) pathway do not have a cancer diagnosed. They are discharged or treated for other conditions. However, patients with new or ongoing symptoms may not return promptly to their doctor because they were reassured following their previous referral or they don’t want to bother their doctor again. This may result in delays in the diagnosis of any future cancers in these patients. Delays in diagnosis may mean the cancer is larger or has spread around the body, meaning it is harder to treat.  

We want to look at the possibility of providing patients with better advice about how to reduce their future cancer risk after they are discharged from a TWW pathway. For instance, patients could be offered information on common cancer signs, when and how to seek help or advice on taking part in cancer screening. We do not currently know the best way to offer this support in the NHS or what would be acceptable to patients. This project will:  

Study 1We will study people who are referred on the TWW pathway for different cancers but are found not to have cancer. We will investigate how many of them go on to develop cancer in the following 5 years.  

Study 2We will interview healthcare providers who are involved in the TWW pathway to increase our understanding of the potential for early diagnosis initiatives in this setting.   

Study 3: We will survey patients who were referred with suspected cancer via the TWW pathway and measure their views on different approaches to providing support 

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