Suspected CANcer (SCAN) Diangostic Pathway
The Oxford Suspected CANcer (SCAN) Pathway was set up with the aim of reducing the time that patients who have non-specific symptoms that could be cancer wait to be diagnosed and the stage at which cancers are diagnosed. The SCAN Pathway has provided evidence that non-specific symptoms pathways are an effective route to diagnosis for people with non-specific symptoms and these types of pathways are now being made available nationally.
A diagnostic pathway is the route that patients take from first visiting a clinician with their symptoms to receiving their diagnosis. People who visit their GP with non-specific symptoms (for example fatigue, weight loss, unexplained pain) often do not meet the criteria to be referred for tests and so can experience long delays before they are diagnosed. This is not only frustrating for the patient but means that if they do have cancer or another serious disease, it could have progressed and become more difficult to treat by the time they are diagnosed.
We also know that England has worse cancer survival rates than other similar European countries and it is estimated that 5,000 deaths from breast, colorectal and lung cancer could be prevented each year if these cancers were diagnosed earlier. To try to improve England’s early diagnosis rates Cancer Research UK (CRUK) set up the ACE project, a programme of research in partnership with other charities, UK universities, and hospitals. The ACE project aimed to identify the barriers to diagnosing cancer more quickly and then to design and test new diagnostic pathways to speed up diagnosis for people with non-specific symptoms. The Oxford SCAN Pathway is one of the diagnostic pathways being tested.
WHAT WE ARE DOING:
The SCAN Pathway was first made available in 2017 to all GPs in Oxfordshire as a route to refer patients aged 40 and over with non-specific symptoms if the GP thinks there is a chance they have cancer. Patients referred to the SCAN Pathway are given blood tests, a stool test (if one has not been done recently), and a CT scan within two week of their referral. Once the clinical team has the results of these tests, the patient is referred either back to their GP, to a specialist clinic, or on for more tests and discussions with a team of clinicians from a range of medical specialties.
We are testing whether people referred to the SCAN Pathway are diagnosed more quickly and at an earlier cancer stage than those with similar symptoms who were not referred to SCAN and comparing their long-term outcomes. We will also be asking GPs and patients about their experience of the Pathway, and calculating whether the costs involved in the Pathway make it more or less cost effective than existing pathways.
By the start of its 6th year, the SCAN Pathway had scanned almost 3,500 patients, providing us with high quality data on whether non-specific symptoms pathways are an effective way to diagnose patients with non-specific symptoms. Although analyses are still ongoing, initial results suggest the SCAN Pathway is effective at diagnosing cancer in these patients. The SCAN Pathway has provided some of the evidence used to justify making non-specific symptom pathways available more widely in the UK, giving patients living outside of Oxfordshire the chance to get their diagnosis more quickly.
We have also set up an additional project to build a research database that contains imaging, laboratory, clinical data, and a biobank of blood and urine samples that is being used by approved researchers to study new ways of diagnosing cancer.