THE RISE IN URGENT SUSPECTED SARCOMA REFERRALS TO A TERTIARY REFERRAL CENTRE AFFECTING CLINIC WAIT TIMES: WHAT ARE THE NEXT STEPS?

On average, a GP will diagnose one sarcoma during their career. NICE guidelines recommend an ultrasound (within 2 weeks) for any unexplained, enlarging lump, and urgent referral (within 2 weeks) if this demonstrates a suspicious lesion. This study evaluated referral numbers and waiting times for urgent suspected cancer (USC) between 2019–24. The number of USC referrals to the Grampian Sarcoma service have significantly increased; 221 USC referrals were received in 2019, 502 in 2020–22 and 689 in 2022–24. In 2019, the mean time from referral to imaging and clinic was 42 and 62 days, respectively. In 2020–22, the mean time from referral to imaging and clinic was 54 days for both. Of the 183 referrals exclusively from GPs, 41% were diagnosed as normal variations or miscellaneous musculoskeletal conditions, 22% were diagnosed as benign lesions on history and examination alone. Overall, 44% of GP referrals were diagnosed without imaging or biopsy. In the 2019, 2020–21, 2021–22 cohorts, there were 7, 5, and 6 sarcomas diagnosed respectively. Since 2019, referral rates have almost doubled, whilst sarcoma incidence has not. Waiting times remain significantly higher than NICE guidelines. The reduction in waiting times from 2019 to 2020–22 can be attributed to the increase in clinics provided by the Sarcoma Surgeons, however continuing this is not sustainable and will impact on treatment of sarcoma. Evidently, a transformation in the referral pathway is required to reduce clinic waiting times for actual sarcoma referrals ensuring timely diagnosis and treatment of this rare but devastating cancer.