BACKGROUND: The principal aim of this study was to determine the feasibility of a large-scale comparative study, between the UK, the Netherlands and Sweden, to investigate whether delays in the diagnostic pathway of cancer might explain differences in cancer survival between countries. METHODS: Following a planning meeting to agree the format of a data collection instrument, data on delays in the cancer diagnostic pathway were abstracted from primary care-held medical records. Data were collected on 50 cases each (total of 150) from practices in each of Grampian, Northeast Scotland; Maastricht, the Netherlands and Skane, Sweden. Data were entered into SPSS 18.0 for analysis. RESULTS: Data on delays in the cancer diagnostic pathway were readily available from primary care-held case records. However, data on demographic variables, cancer stage at diagnosis and treatment were less well recorded. There was no significant difference between countries in the way in which cases were referred from primary to secondary care. There was no significant difference between countries in the time delay between a patient presenting in primary care and being referred to secondary care. Median delay between referral and first appointment in secondary care [19 (8.0-47.5) days] was significantly longer in Scotland that in Sweden [1.0 (0-31.5) days] and the Netherlands [5.5 (0-31.5) days] (P < 0.001). Secondary care delay (between first appointment in secondary care and diagnosis) in Scotland [22.5 (0-39.5) days] was also significantly longer than in Sweden [14.0 (4.5-31.5) days] and the Netherlands [3.5 (0-16.5) days] (P = 0.003). Finally, overall delay in Scotland [53.5 (30.3-96.3) days] was also significantly longer than in Sweden [32.0 (14.0-71.0) days] and the Netherlands [22.0 (7.0-60.3) days] (P = 0.003). CONCLUSIONS: A large-scale study comparing cancer delays in European countries and based on primary care-held records is feasible but would require supplementary sources of data in order to maximize information on demographic variables, the cancer stage at diagnosis and treatment details. Such a large-scale study is timely and desirable since our findings suggest systematic differences in the way cancer is managed in the three countries.
BACKGROUND: The principal aim of this study was to determine the feasibility of a large-scale comparative study, between the UK, the Netherlands and Sweden, to investigate whether delays in the diagnostic pathway of cancer might explain differences in cancer survival between countries. METHODS: Following a planning meeting to agree the format of a data collection instrument, data on delays in the cancer diagnostic pathway were abstracted from primary care-held medical records. Data were collected on 50 cases each (total of 150) from practices in each of Grampian, Northeast Scotland; Maastricht, the Netherlands and Skane, Sweden. Data were entered into SPSS 18.0 for analysis. RESULTS: Data on delays in the cancer diagnostic pathway were readily available from primary care-held case records. However, data on demographic variables, cancer stage at diagnosis and treatment were less well recorded. There was no significant difference between countries in the way in which cases were referred from primary to secondary care. There was no significant difference between countries in the time delay between a patient presenting in primary care and being referred to secondary care. Median delay between referral and first appointment in secondary care [19 (8.0-47.5) days] was significantly longer in Scotland that in Sweden [1.0 (0-31.5) days] and the Netherlands [5.5 (0-31.5) days] (P < 0.001). Secondary care delay (between first appointment in secondary care and diagnosis) in Scotland [22.5 (0-39.5) days] was also significantly longer than in Sweden [14.0 (4.5-31.5) days] and the Netherlands [3.5 (0-16.5) days] (P = 0.003). Finally, overall delay in Scotland [53.5 (30.3-96.3) days] was also significantly longer than in Sweden [32.0 (14.0-71.0) days] and the Netherlands [22.0 (7.0-60.3) days] (P = 0.003). CONCLUSIONS: A large-scale study comparing cancer delays in European countries and based on primary care-held records is feasible but would require supplementary sources of data in order to maximize information on demographic variables, the cancer stage at diagnosis and treatment details. Such a large-scale study is timely and desirable since our findings suggest systematic differences in the way cancer is managed in the three countries.
Authors: David Weller; Peter Vedsted; Chantelle Anandan; Alina Zalounina; Evangelia Ourania Fourkala; Rakshit Desai; William Liston; Henry Jensen; Andriana Barisic; Anna Gavin; Eva Grunfeld; Mats Lambe; Rebecca-Jane Law; Martin Malmberg; Richard D Neal; Jatinderpal Kalsi; Donna Turner; Victoria White; Martine Bomb; Usha Menon Journal: BMJ Open Date: 2016-07-25 Impact factor: 2.692
Authors: Michael Harris; Peter Vedsted; Magdalena Esteva; Peter Murchie; Isabelle Aubin-Auger; Joseph Azuri; Mette Brekke; Krzysztof Buczkowski; Nicola Buono; Emiliana Costiug; Geert-Jan Dinant; Gergana Foreva; Svjetlana Gašparović Babić; Robert Hoffman; Eva Jakob; Tuomas H Koskela; Mercè Marzo-Castillejo; Ana Luísa Neves; Davorina Petek; Marija Petek Ster; Jolanta Sawicka-Powierza; Antonius Schneider; Emmanouil Smyrnakis; Sven Streit; Hans Thulesius; Birgitta Weltermann; Gordon Taylor Journal: BMJ Open Date: 2018-09-05 Impact factor: 2.692
Authors: Usha Menon; Peter Vedsted; David Weller; Alina Zalounina Falborg; Henry Jensen; Andriana Barisic; Anne Kari Knudsen; Rebecca J Bergin; David H Brewster; Victoria Cairnduff; Anna T Gavin; Eva Grunfeld; Elizabeth Harland; Mats Lambe; Rebecca-Jane Law; Yulan Lin; Martin Malmberg; Donna Turner; Richard D Neal; Victoria White; Samantha Harrison; Irene Reguilon Journal: BMJ Open Date: 2018-11-27 Impact factor: 2.692