Cancer is the second leading cause of mortality worldwide. Integrating different levels of care by implementing screening programs, extending diagnostic tools and applying therapeutic advances may increase survival. We implemented a cancer fast-track program (CFP) to reduce time from suspected cancer symptoms to confirmation of diagnosis and start of therapy.
A descriptive data sample of ten years since implementation of the CFP (2009–2019) were collected at the Clinico-Malvarrosa Health Department in Valencia, Spain. Aiming to shorten time between suspected cancer cases and diagnosis, primary care (PC) physicians, an oncology coordinator and eleven specialists designed guidelines for PC physicians to refer patients through the CFP. Recommendations stablished in the guides included some for potential breast, colorectal, cervical, lung, bladder, dermatological, head and neck and soft tissue cancers. Patients with enlarged lymph nodes and constitutional symptoms were also considered. When the PC physician identified patients with suspected cancer, a proposal was sent for further review to the oncology coordinator. If recommendations were met, a quick appointment was made to attend the patient. We analysed the time lapse between each stage of the process during a ten year follow up.
A total of 4574 suspected cancer cases were submitted to the CFP; 4405 were seen by the corresponding specialist. In 1102 (25%) cases, cancer was confirmed. Among these, breast cancer was found in 29%; urological 21%; colorectal 17%; and lung cancer 14%. The median time from submission of a proposal to the specialist assessment was 15 days (1-136); 3 days (1-242) to pathological diagnosis and 34 days (1-333) to treatment. In 832/1102 (74.5%) treatment intention was curative.
Interval between patient referral by the PC physician to the specialist, diagnosis of cancer and start of therapy can be reduced. The implementation of CFT allowed most patients to begin curative intended therapy. Our implemented CFP requires a limited amount of resources.
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All authors have declared no conflicts of interest.