Pathways to cancer diagnosis: Monitoring variation in the patient journey across Northern Ireland Business Services Organisation Information Unit, Health and Social Care Northern Ireland

  • Being run by the Business Services Organisation Information Unit, with analytical support from Queen’s University Belfast.
  • Aiming to improve understanding of the variation in routes-to-diagnosis (for example screen-detected, GP referral, emergency presentation) of cancer in Northern Ireland, in order to increase earlier diagnoses and treatment effectiveness.
  • Will estimate routes-to-diagnosis at different health geographies down to GP practice level, and create an online tool for health service practitioners. 
  • Running from March 2018 to June 2019.

Although cancer survival in Northern Ireland is improving, it still lags behind other European countries. This is partly due to late Stage 4 presentation, which accounts for one in five cancers. Differing routes-to-diagnosis are associated with this advanced disease presentation and poor survival rates.

Using multiple routine datasets and building on the methods developed by the National Cancer Registration and Analysis Service, this project will, for the first time, allow for a comprehensive analysis of the different routes-to-diagnosis of cancer patients in Northern Ireland.

Reports will show the profile of routes-to-diagnosis by cancer type where analysis can be carried out in Northern Ireland, and will contain key information such as survival rates and demographic differences across each of the routes-to-diagnosis.

Identifying and categorising cancer patients by their route-to-diagnosis, and estimating mean survival for these categories, can help develop an understanding of how patients with a poor prognosis enter secondary care. This analysis, when repeated by cancer sites with different prognoses, may provide insights into the dynamic that exists between routes-to-diagnosis and cancer survival. 

The study also aims to assess if there is meaningful statistical variation across Northern Ireland in patients moving through different routes-to-diagnosis (with a focus on emergency presentations). 

Measures will be presented in an interactive tool whereby varying cancer sites, health geographies down to GP practice level, and time periods can be explored.

It is hoped that the routes-to-diagnosis reports and interactive tool will be adopted by Health and Social Care Northern Ireland practitioners and be updated annually to provide an evidence base for the evaluation of cancer service delivery in Northern Ireland. 

Indicators at GP practice level do not exist in any UK country and, dependent on their assessed robustness, could help targeting of resources towards outlying areas in the form of awareness and early diagnosis initiatives.

Contact information

For more information about this project, please contact Alan Harbinson, Deputy Head of Information and Registration Unit, Business Services Organisation, Northern Ireland.

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