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

Although cancer survival in Northern Ireland is improving, it still lags behind other European countries, partly due to late-stage presentation. Notably, the circumstances under which a person is diagnosed with cancer can strongly influence their subsequent survival.

‘Routes-to-diagnosis’ analysis is a novel methodology developed by Public Health England, which classifies cancer patients based on the health care events that lead to their diagnosis (eg cancer screening, GP referral, emergency presentation). Such an approach can help transform the care pathway by focusing attention on promoting symptom awareness, early diagnosis and effective treatment.

This project applied the routes-to-diagnosis methodology to Northern Ireland datasets for cancer patients diagnosed from 2012 to 2016. A comprehensive report providing analysis across all the main cancer sites broken down by a range of factors, including gender, age, deprivation, disease stage and survival, was produced.

Comparisons with England revealed that although rates of screening and emergency presentation were similar, significant numbers of patients still enter the health system through emergency routes and with late-stage presentation in Northern Ireland.

An intuitive interactive online tool was developed to give health service practitioners access to detailed information by selecting data breakdowns, tables and graphs, and exploring findings on less common cancers. Although still a prototype, the tool received positive feedback on its ease-of-use for data comparison.

Despite encountering data quality issues, the project team greatly enhanced their analytical capabilities, particularly in the use of R Studio for producing data visualisations, and developed recommendations on improvements to methodology and interpretation for any future iterations of their work.

This sophisticated analysis clearly highlights the need for further investigation to promote earlier cancer diagnosis and provides an evidence base that will inform the evaluation of cancer service delivery in Northern Ireland, including the new 10-year cancer strategy.

Contact information

For more information about this project, please contact Alan Harbinson, Head of Honest Broker Advice Service, Health and Social Care Northern Ireland (Business Services Organisation).