Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster Display session 3

4433 - Acute Diagnostic Oncology Clinic: A Unique Primary Care-Oncology Service

Date

30 Sep 2019

Session

Poster Display session 3

Presenters

Abhijit Gill

Citation

Annals of Oncology (2019) 30 (suppl_5): v671-v682. 10.1093/annonc/mdz263

Authors

A. Gill, R. Sharkey, J. Simmons, M. Bower, A. Sita-Lumsden, J. Evans, T. Newsom-Davis

Author affiliations

  • Oncology, Chelsea & Westminster Hospital, SW10 - London/GB
More

Resources

Abstract 4433

Background

Cancers presenting with ‘vague symptoms’ are difficult to diagnose. These non-specific but serious symptoms (weight loss, anorexia, pain, fatigue) have a number of causes including malignancy. The risk for each individual cancer may be low, but the total risk of cancer of any type is higher. Patients diagnosed with cancer as the result of an emergency presentation (EP) to secondary care have poorer survival, usually describe a long history of symptoms, and most have seen their general practitioner (GP) prior to presentation. Earlier diagnosis improves cancer outcomes. But investigating vague symptoms is challenging, requiring both oncology and general medical knowledge, while bespoke rapid-access oncology diagnostic clinics are needed to avoid EP.

Methods

The Acute Diagnostic Oncology Clinic was established at Chelsea & Westminster Hospital in 2016. It initially provided rapid access investigations for those too ill to wait for an urgent suspected cancer appointment, as an alternative to the Emergency Department (ED). In February 2018 the clinic expanded to, uniquely, include a GP with specialist interest in oncology and patients with ‘vague symptoms’.

Results

361 referrals were received, 65% were female. Weight loss was the commonest vague symptom (50%). Initially, 96% of patients were seen within 24 hours of referral, falling to 69% after expansion of the clinic remit in 2018. 34% of patients (from 2018, 21%) were diagnosed with cancer. Mean time from referral to diagnosis was 4 days, and to starting cancer treatment it was 20 days. A range of cancers were identified, lung the commonest, and advanced stage disease the most likely. A number of significant non-malignant conditions were diagnosed. One-third of patients provided feedback. Only 37% were told at referral that cancer was suspected. The service was rated Excellent or Very Good in all cases. 84% valued being seen urgently. Feedback was received from 40 GPs. 100% would use the service again. Alternate referral routes would have been routine cancer referral (60%) or ED (13%).

Conclusions

To our knowledge, this is the only GP-oncology led rapid access cancer diagnostic clinic. Combining general medical and oncology expertise is an effective approach for diagnosing patients with vague symptoms and tackling EP cancer.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

CW+ Healthcare Charity.

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings