Characterization of patients with suspicion of malignancy referred to a dedicated cancer center.

157 Background: Suspected cancer is often challenging to navigate and time-sensitive. Delays in diagnosis are associated with worse outcomes, particularly for patients whose initial presentation occurs in the emergency department. Many patients initially present with nonspecific symptoms or imaging findings, resulting in multiple primary care visits before a diagnosis is made. Specialized cancer centers often require a confirmed diagnosis prior to scheduling new patient visits, contributing to delays in access to oncologic care. In response, the Fred Hutchinson Cancer Center established the Undiagnosed Mass (UDM) Clinic to streamline evaluation and expedite care for patients with suspected malignancy. Methods: This retrospective chart review included adult patients (age ≥18) referred to the UDM Clinic between July 2022 to June 2024. Patients were either directly referred or routed to this clinic if they had objective concerns for malignancy, lacked pathologic diagnosis, or did not have a clearly defined primary tumor. Data from the patients seen in the UDM Clinic were abstracted for this analysis. Data were abstracted from medical records to characterize demographics, referral sources, time to consultation, time from consultation to diagnosis, and time from diagnosis to initiation of treatment. Results: A total of 114 patients were evaluated (median age 59 years; range 18–91; 43% female). Most were referred from primary care (48.2%), followed by specialists (19.3%), emergency departments (16.7%), and self-referrals (13.2%). The median time from referral to initial UDM consultation was 11 days (8 days for patients later diagnosed with cancer (n = 58), 13 days for those with non-malignant conditions (n = 56)). Biopsies were performed in 75.4% (n = 86), with malignancy confirmed in 67.4% (n = 58 of 86). Lymphoma was the most frequent diagnosis (41.4% of malignancies). The median time from UDM consultation to a pathologic diagnosis was 9.5 days for cases with malignant diagnosis and 18 days for a non-malignant diagnosis. The median time from consultation to initiation of cancer-directed therapy was 50.5 days. Conclusions: The UDM Clinic represents a promising model for improving the timeliness of diagnosis and access to specialized care for patients with suspected cancer. Early entry into this pathway may support more rapid diagnosis and treatment, reduce unnecessary primary care visits, and help avoid inpatient hospitalizations for cancer workups—ultimately easing strain on the broader healthcare system.