ANALYZING TRENDS IN DELAYS TO ASSESSMENT AT A TERTIARY DIAGNOSTIC SARCOMA CENTRE

NICE set out a clear, structured approach for the early recognition and appropriate urgent referral of suspected bone and soft tissue sarcomas. Wide scale, UK based analysis of this structure shows that it results in a significant improvement in the 5-year disease-specific survival of patients. Despite this, Sarcoma patients are significantly less likely to be referred via the urgent two week waiting programme than other malignancies, with prolonged diagnostic intervals, averaging close to 90 days, remaining the norm. To evaluate trends in delays along diagnostic pathway for patients referred to a Scottish Tertiary Sarcoma Centre, by analysing the time interval and sequence of events from initial General Practitioner presentation, to review in a specialist Sarcoma Clinic, over a period of 7 years (2015-2022). A retrospective cohort study was conducted, data extracted from electronic medical records, including dates of first general practitioner presentation, referral pathway used and first specialist sarcoma clinic appointment, along with key intermediate steps in the diagnostic pathway. Time intervals were calculated between defined pathway points. The mean wait for patients referred urgently via the suspected cancer pathway from primary care fall within accepted timeframes. However significant delays still exist for patients who are referred to peripheral centres or not referred urgently (close to 90 days) or initially referred to another tertiary speciality (up to 240 days). Overall, variation in referral pathway was a key determinant of time to specialist assessment, with non-urgent and indirect routes associated with substantially increased delays.