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Analysing NHS data to improve early diagnosis and guide interventions

Addressing gaps in data is vital for monitoring progress towards the 2028 ‘early-stage’ target and optimising diagnostic services and pathways.

Illustration of scientists working on ideas

20 June 2024

Background


Evidence on the frequency and nature of help-seeking for possible cancer symptoms (including those included in ‘Be Clear on Cancer’ campaigns) is lacking. Inequalities in consultation patterns by ethnicity and deprivation exist, but the type of symptoms involved, inequalities in presentation and cancer risk are poorly understood. Evidence is also needed to achieve earlier diagnosis for primary care consultees with as-yet-undiagnosed cancer. Thus far, evidence (and therefore NICE guidelines) do not cater to the half of all patients with undiagnosed cancer, whose initial cancer risk is lower than 3% (the NICE referral threshold).

This group typically comprises younger patients and those presenting with non-specific symptoms (loss of weight, fatigue, etc.) when those are considered on their own. Finally, evidence on time trends in key metrics of early detection and diagnosis and related inequalities in such trends (patient level or geographic) is critical for guiding policy, but is currently lacking. Addressing this gap is vital for monitoring progress towards the 2028 ‘early-stage’ target, to hep prioritise early diagnosis policies, target improvement efforts, and optimise diagnostic services and pathways.   

Aims and objectives


  • To benchmark patterns of primary care activity related to a large range of symptoms, alongside patient group inequalities in help-seeking for different symptoms, and associated risk of cancer. 
  • To improve risk stratification for patients presenting with non-specific symptoms and low risk groups (including younger patients). 
  • To examine variation in markers of early diagnosis, alongside diagnostic management activity: over time, between patient groups, between relevant NHS geographies. To develop approaches to enable routine monitoring of geographical variation. To quantify survival gains attainable by improving and/or removing inequalities in markers of early diagnosis. 

Policy Relevance & Dissemination  


By achieving these aims, we will provide an infrastructure for evaluating the effectiveness of public health campaigns for symptoms and identify targets for future waves of these interventions and their likely impact. We will help to enhance and update NICE guidelines, to improve classification of risk in patients with characteristics/symptoms averagely associated with risk below the 3% threshold, and hope to learn lessons from progress / lack of progress thus far and identify opportunities for targeted policies towards attaining the early stage 2028 target. 

This will be shared through direct engagement with policymakers such as the DHSC policy teams, NHS England Cancer Teams, Office for Health Inequalities and Disparities (OHID), NHS Screening, Cancer Research UK Policy, and RCGP.  

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The NIHR Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis is part of the NIHR and hosted by UCL.