Module 4

A study investigating the root causes of diagnosis and treatment delays in four cancer sites (breast, lung, colorectal, and ovarian).

Cancer survival in NI, although improving, lags behind that of many countries for lung, breast, colon, rectum and ovarian cancer (Coleman et al 2011). The reasons for poorer survival may lie with delayed diagnosis. Late diagnosis of cancer can be caused by late patient presentation or delays in primary or hospital care. In NI, 64% of lung cancer patients presented with late stage disease and only 11% were suitable for curative surgery (Bannon & Gavin 2009).  In addition, 43% of colon cancers present as emergencies, while 57% of screen age women with breast cancer present outside of screening. Earlier diagnosis is known to improve survival.

The variation of outcomes in cancer survival across countries with similar levels of spending and resources remains unexplained. There is a wide range of views but a lack of clear evidence as to why cancer outcomes vary and therefore about how resources can be used most effectively. Survival differences can arise from many factors including patient characteristics, nature of diagnostic and screening services, cultural and societal factors and quality of treatments available.

This project will explore differences in total delay in the pathway to treatment for four cancers (breast, lung, colorectal and ovarian) and the contribution of different elements to that delay (e.g. patient, primary care, and hospital delays). Data collected will allow international comparison of the NI results to the 11 other jurisdictions.

‌

‌

‌

‌

‌

‌