Rapid Diagnostic Centres and early cancer diagnosis
Erridge, S, Lyratzopoulos, G, Renzi, C, Millar, A, Lee, R
Abstract
Early cancer diagnosis is a clinical and research priority of the UK government.Earlier cancer diagnosis should enable identification of cancers at an earlier stage, leading to improved outcomes. 1 This must be balanced with the potential physical and psychological harms of over-investigation and over-diagnosis.The 'two-week wait' (2WW) referral pathway represents the most common route to cancer diagnosis.However, only 39% of cancer diagnoses were made via 2WW pathways in 2017, while significant proportions of diagnoses are made via other outpatient clinics (32%) or emergency presentation (19%), representing potentially missed diagnostic opportunities. 2 Approximately 50% of cancer patients present with non-specific but concerning symptoms of cancer (NSCS). 3Compared to 'alarm symptoms' these have low predictive values for cancer and are less indicative of site-specific disease; consequently, they are not reflected in 2WW referral criteria. 3hese patients frequently are referred later for specialist investigation and have more advanced disease. 4 A principal goal for the new NHS Rapid Diagnostic Centres (RDCs) is to provide a pathway for patients with NSCS to detect cancer earlier, where treatment outcomes are more favourable. 1NHS England aims to provide full population coverage with RDCs by 2024.