A service evaluation on the efficiency and viability of the accelerated 'GI10' Cancer Staging Pathway

Congress:

ECR 2020

Poster Number:

C-09086

Type:

Scientific Exhibit

Keywords:

Multicentre study, Cross-sectional study, Retrospective, Cancer, Outcomes analysis, Efficacy studies, Colonography CT, Ultrasound, CT, Stomach (incl. Oesophagus), Oncology, Oncologic Imaging

Authors:

U. H. Asim, R. E. Owen; Cardiff/UK

DOI:

10.26044/ecr2020/C-09086

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-09086

Fig. 1: 5-year survival of colorectal cancer in Wales relative to other developed...

Table 1: Scanning and reporting times

Table 2: Pathway checkpoints from the point of endoscopy

Fig. 3: Comparison of scanning and reporting times between accelerated GI10 patients vs...

Purpose

The International Cancer Benchmarking Partnership (ICBP) identified that cancer survival rates in Wales, United Kingdom, are low compared to other developed countries, with diagnostic waits being amongst the longest. [1] See Figure 1. In response, the Cancer Delivery Plan for Wales (2016-2020) committed to the development of a new 62-day Single Cancer Pathway (SCP), replacing the previous Urgent Suspected Cancer (USC) and non-USC pathways. This had a new diagnostic target of 28-days from the point of suspicion of cancer to the last diagnostic test being...

Methods and materials

Conducted at two sites within the Cardiff & Vale Health Board: University Hospital of Wales (UHW) and University Hospital of Llandough (UHL). Data analysis of 165 consecutive patients found to have a malignancy on endoscopy between January and June 2019; including a combination ofGI10 (n=115) and non-GI10 (n=50) pathway patients. Wait time at each stage of the diagnostic pathway (figure 2) was determined and compared (95% confidence interval) betweenGI10 and non-GI10 patients.

Results

Same-day targets As per the GI10 protocol, anyone with an endoscopic finding of GI malignancy was to be scanned and reported same-day. 80.1% of GI10 patients were scanned same-day, compared to 0% for non-GI10 patients. After 7 days, 94.0% of GI10 patients had been scanned and 85.2% had been reported as well. This compares to 52.0% and 40.0% respectively for non-GI10 patients (figure 3). Pathway progression GI10 patients progressed faster at each stage of the diagnostic pathway (figure 4). Note: Under the new SCP, the...

Conclusion

The accelerated GI10 pathway reduced the mean diagnostic waiting time by an average of 15.1 days compared to the non-accelerated group, with the majority of accelerated patients being scanned on the same day (80.1%). AllGI10 patients (whether initially referred for endoscopy as USC or not) fell within the new 28-day SCP diagnostic target, presuming the USC endoscopy target of 14 days was met. Whereas amongst non-GI10 patients, those referred for endoscopy as USC would fail to meet the 28-day target. CT reporting was identified as...

Personal information and conflict of interest

U. H. Asim; Cardiff University School of Medicine, Wales, United Kingdom. Email: [email protected] R. Ellis-Owen, MD; Consultant Radiologist, University Hospital of Wales, Cardiff, United Kingdom.

References

[1] De Angelis R et al (2014). Cancer survival in Europe 1999-2007 by country and age: results of EUROCARE-5- a population-based study. The Lancet Oncology 2014, Jan; 15(1): 23-34. [2] The Royal College of Radiologists (2019). Clinical Radiology UK Workforce Census Report 2018.