Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study

Sewell, Berni; Jones, Mari; Gray, Helen; Wilkes, Heather; Lloyd-Bennett, Catherine; Beddow, Kim; Bevan, Martin; Fitzsimmons, Deborah

doi:10.3399/bjgp20x708077

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Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study

Berni Sewell, Mari Jones

, Helen Gray, Heather Wilkes, Catherine Lloyd-Bennett, Kim Beddow, Martin Bevan, Deborah Fitzsimmons

British Journal of General Practice, Volume: 70, Issue: 692, Pages: e186 - e192

Swansea University Authors: Berni Sewell, Mari Jones , Deborah Fitzsimmons

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DOI (Published version): 10.3399/bjgp20x708077

Abstract

Background: A pilot rapid diagnosis centre (RDC) allows GPs within targeted clusters to refer adults with vague and/or non-specific symptoms suspicious of cancer, who do not meet criteria for referral under an urgent suspected cancer (USC) pathway, to a multidisciplinary RDC clinic where they are se...

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Published in:	British Journal of General Practice
ISSN:	0960-1643 1478-5242
Published:	Royal College of General Practitioners 2020
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa53256

first_indexed	2020-01-14T19:34:06Z
last_indexed	2025-04-10T05:37:04Z
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Aim: To explore the cost-effectiveness of the RDC compared with standard clinical practice. Design and setting: Cost-effectiveness modelling using routine data from Neath Port Talbot Hospital, Wales. Method: Discrete-event simulation modelled a cohort of 1000 patients from referral to radiological diagnosis based on routine RDC and hospital data. Control patients were those referred to a USC pathway but then downgraded. Published sources provided estimates of patient quality of life (QoL) and pre-diagnosis anxiety. The model calculates time to diagnosis, costs, and quality-adjusted life years (QALYs), and estimates the probability of the RDC being a cost-effective strategy. Results: The RDC reduces mean time to diagnosis from 84.2 days in usual care to 5.9 days if a diagnosis is made at clinic, or 40.8 days if further investigations are booked during RDC. RDC provision is the superior strategy (that is, less costly and more effective) compared with standard clinical practice when run near or at full capacity. However, it is not cost-effective if capacity utilisation drops below 80%. 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spelling	2025-04-09T14:42:01.0260558 v2 53256 2020-01-14 Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study f6a4af2cfa4275d2a8ebba292fa14421 Berni Sewell Berni Sewell true false 8e326860810f5f960b088db10ef58906 0000-0001-9661-4899 Mari Jones Mari Jones true false e900d99a0977beccf607233b10c66b43 0000-0002-7286-8410 Deborah Fitzsimmons Deborah Fitzsimmons true false 2020-01-14 Background: A pilot rapid diagnosis centre (RDC) allows GPs within targeted clusters to refer adults with vague and/or non-specific symptoms suspicious of cancer, who do not meet criteria for referral under an urgent suspected cancer (USC) pathway, to a multidisciplinary RDC clinic where they are seen within 1 week. Aim: To explore the cost-effectiveness of the RDC compared with standard clinical practice. Design and setting: Cost-effectiveness modelling using routine data from Neath Port Talbot Hospital, Wales. Method: Discrete-event simulation modelled a cohort of 1000 patients from referral to radiological diagnosis based on routine RDC and hospital data. Control patients were those referred to a USC pathway but then downgraded. Published sources provided estimates of patient quality of life (QoL) and pre-diagnosis anxiety. The model calculates time to diagnosis, costs, and quality-adjusted life years (QALYs), and estimates the probability of the RDC being a cost-effective strategy. Results: The RDC reduces mean time to diagnosis from 84.2 days in usual care to 5.9 days if a diagnosis is made at clinic, or 40.8 days if further investigations are booked during RDC. RDC provision is the superior strategy (that is, less costly and more effective) compared with standard clinical practice when run near or at full capacity. However, it is not cost-effective if capacity utilisation drops below 80%. Conclusion: An RDC for patients presenting with vague or non-specific symptoms suspicious of cancer in primary care reduces time to diagnosis and provides excellent value for money if run at ≥80% capacity. Journal Article British Journal of General Practice 70 692 e186 e192 Royal College of General Practitioners 0960-1643 1478-5242 cancer diagnosis; cost-effectiveness; early detection of cancer; general practice; nonspecific symptoms; rapid diagnosis centre 1 3 2020 2020-03-01 10.3399/bjgp20x708077 COLLEGE NANME COLLEGE CODE Swansea University Cancer Research UK (CRUK) 2025-04-09T14:42:01.0260558 2020-01-14T14:15:32.0392994 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Berni Sewell 1 Mari Jones 0000-0001-9661-4899 2 Helen Gray 3 Heather Wilkes 4 Catherine Lloyd-Bennett 5 Kim Beddow 6 Martin Bevan 7 Deborah Fitzsimmons 0000-0002-7286-8410 8 53256__16862__413ee96319c84d43a4f74b3c62fd7c21.pdf 53256.pdf 2020-03-17T11:57:31.7437457 Output 110324 application/pdf Version of Record true Released under the terms of a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). true eng https://creativecommons.org/licenses/by-nc/4.0/
title	Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study
spellingShingle	Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study Berni Sewell Mari Jones Deborah Fitzsimmons
title_short	Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study
title_full	Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study
title_fullStr	Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study
title_full_unstemmed	Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study
title_sort	Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study
author_id_str_mv	f6a4af2cfa4275d2a8ebba292fa14421 8e326860810f5f960b088db10ef58906 e900d99a0977beccf607233b10c66b43
author_id_fullname_str_mv	f6a4af2cfa4275d2a8ebba292fa14421_*_Berni Sewell 8e326860810f5f960b088db10ef58906__Mari Jones e900d99a0977beccf607233b10c66b43_**_Deborah Fitzsimmons
author	Berni Sewell Mari Jones Deborah Fitzsimmons
author2	Berni Sewell Mari Jones Helen Gray Heather Wilkes Catherine Lloyd-Bennett Kim Beddow Martin Bevan Deborah Fitzsimmons
format	Journal article
container_title	British Journal of General Practice
container_volume	70
container_issue	692
container_start_page	e186
publishDate	2020
institution	Swansea University
issn	0960-1643 1478-5242
doi_str_mv	10.3399/bjgp20x708077
publisher	Royal College of General Practitioners
college_str	Faculty of Medicine, Health and Life Sciences
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hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
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hierarchy_parent_title	Faculty of Medicine, Health and Life Sciences
department_str	School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
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description	Background: A pilot rapid diagnosis centre (RDC) allows GPs within targeted clusters to refer adults with vague and/or non-specific symptoms suspicious of cancer, who do not meet criteria for referral under an urgent suspected cancer (USC) pathway, to a multidisciplinary RDC clinic where they are seen within 1 week. Aim: To explore the cost-effectiveness of the RDC compared with standard clinical practice. Design and setting: Cost-effectiveness modelling using routine data from Neath Port Talbot Hospital, Wales. Method: Discrete-event simulation modelled a cohort of 1000 patients from referral to radiological diagnosis based on routine RDC and hospital data. Control patients were those referred to a USC pathway but then downgraded. Published sources provided estimates of patient quality of life (QoL) and pre-diagnosis anxiety. The model calculates time to diagnosis, costs, and quality-adjusted life years (QALYs), and estimates the probability of the RDC being a cost-effective strategy. Results: The RDC reduces mean time to diagnosis from 84.2 days in usual care to 5.9 days if a diagnosis is made at clinic, or 40.8 days if further investigations are booked during RDC. RDC provision is the superior strategy (that is, less costly and more effective) compared with standard clinical practice when run near or at full capacity. However, it is not cost-effective if capacity utilisation drops below 80%. Conclusion: An RDC for patients presenting with vague or non-specific symptoms suspicious of cancer in primary care reduces time to diagnosis and provides excellent value for money if run at ≥80% capacity.
published_date	2020-03-01T10:54:43Z
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Rapid cancer diagnosis for patients with vague symptoms: a cost-effectiveness study

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