National Cancer Diagnosis Audit: avoidable delays to diagnosis

Background A prolonged time taken to diagnose cancer can lead to poorer survival and reduced quality of life. Characterising avoidable delays to a patient’s diagnosis could help to direct quality improvement initiatives aimed at enhancing patient safety and ultimately patient outcomes. Aim To assess the validity of data on avoidable delays collected as part of the English National Cancer Diagnosis Audit (NCDA) and to estimate the predictors of avoidable delays to diagnosis by patient demographics and cancer type. Method Participating general practices (n = 439; 5% practices) submitted primary care data on patients (n = 17 042) diagnosed with cancer in 2014 in England. GPs reported delays to the diagnosis that they considered avoidable. Quantile regression was used to understand the impact of an avoidable delay on the diagnostic interval. Logistic regression models were used to investigate the factors associated with avoidable delay. Results The GP recorded an avoidable delay to cancer diagnosis in 24% of cases (n = 3372). The median diagnostic interval was 57 days longer in patients where an avoidable delay was recorded. Results have shown significant associations between avoidable delay and certain cancer types (odds ratio [OR] 1.73 for stomach versus lung cancer) and an increasing number of comorbidities (OR 1.43 for patients with ≥3 versus 0). Conclusion GP-reported data showed a longer diagnostic interval in patients thought to have had an avoidable delay to their diagnosis, indicating construct validity of the data collected. Data from the NCDA is being used to better understand avoidable delays to diagnosis, and identify possible solutions for improving the diagnostic pathway in some cases.