Annual Cancer Waiting Times statistics for urgently-referred patients by tumour site and NHS board, for Acute Leukaemia and Paediatric cancers.

To remain relevant to the changing set of targets, the quarterly Cancer Waiting Times Statistics published previously by ISD was replaced by the New Cancer Waiting Times Statistics in June 2010, which show a new series of figures. The Cancer Waiting Times' last quarterly release was in May 2010.

Source agency: ISD Scotland (part of NHS National Services Scotland)

Designation: Official Statistics not designated as National Statistics

Language: English

Alternative title: Cancer Waiting Times

BackgroundCancer Waiting Time targets have been integrated into successive cancer strategies as indicators of cancer care quality in England. These targets are reported in national statistics for all cancers combined, but there is mixed evidence of their benefits and it is unclear if meeting Cancer Waiting Time targets, as currently defined and published, is associated with improved survival for individual patients, and thus if survival is a good metric for judging the utility of the targets.Methods and findingsWe used individually-linked data from the National Cancer Waiting Times Monitoring Dataset (CWT), the cancer registry and other routinely collected datasets. The study population consisted of all adult patients diagnosed in England (2009–2013) with colorectal (164,890), lung (171,208) or ovarian (24,545) cancer, of whom 82%, 76%, and 77%, respectively, had a CWT matching record.The main outcome was one-year net survival for all matched patients by target attainment (‘met/not met’). The time to each type of treatment for the 31-day and 62-day targets was estimated using multivariable analyses, adjusting for age, sex, tumour stage and deprivation.The two-week wait (TWW) from GP referral to specialist consultation and 31-day target from decision to treat to start of treatment were met for more than 95% of patients, but the 62-day target from GP referral to start of treatment was missed more often. There was little evidence of an association between meeting the TWW target and one-year net survival, but for the 31-day and 62-day targets, survival was worse for those for whom the targets were met (e.g. colorectal cancer: survival 89.1% (95%CI 88.9–89.4) for patients with 31-day target met, 96.9% (95%CI 96.1–91.7) for patients for whom it was not met). Time-to-treatment analyses showed that treatments recorded as palliative were given earlier in time, than treatments with potentially curative intent.There are possible limitations in the accuracy of the categorisation of treatment variables which do not allow for fully distinguishing, for example, between curative and palliative intent; and it is difficult in these data to assess the appropriateness of treatment by stage. These limitations in the nature of the data do not affect the survival estimates found, but do mean that it is not possible to separate those patients for whom the times between referral, decision to treat and start of treatment could actually have an impact on the clinical outcomes. This means that the use of these survival measures to evaluate the targets would be misleading.ConclusionsBased on these individually-linked data, and for the cancers we looked at, we did not find that Cancer Waiting Time targets being met translates into improved one-year survival. Patients may benefit psychologically from limited waits which encourage timely treatment, but one-year survival is not a useful measure for evaluating Trust performance with regards to Cancer Waiting Time targets, which are not currently stratified by stage or treatment type. As such, the current composition of the data means target compliance needs further evaluation before being used for the assessment of clinical outcomes.

From February 2021, data is only published for the suspected cancer pathway. Targets for the urgent and not via the urgent pathway have ceased and no new data will be collected or published for these pathways. The patients shown here are those newly diagnosed with cancer who started definitive treatment via the Urgent Suspected Cancer route. The national target for these patients is: at least 95 per cent of patients diagnosed with cancer, via the urgent suspected cancer route will start definitive treatment within 62 days of receipt of referral. From 1st April 2019 health service provision for residents of Bridgend local authority moved from Abertawe Bro Morgannwg to Cwm Taf. For more information see the joint statement from Cwm Taf and Abertawe Bro Morgannwg University Health Boards (see weblinks). The health board names have changed with Cwm Taf University Health Board becoming Cwm Taf Morgannwg University Health Board and Abertawe Bro Morgannwg University Health Board becoming Swansea Bay University Health Board. A link to the statement from the minister for health and social service can be found in the weblinks section.

Details information on the waiting times for patients accessing cancer services at hospitals in Northern Ireland. This information reports on the performance of Health and Social Care (HSC) Trusts against the ministerial targets (62 day, 31 day and 14 day) in Northern Ireland.

The waiting time of people referred by their GP with suspected cancer or breast symptoms and those subsequently diagnosed with and treated for cancer, by London NHS hospital and Primary Care Trust (PCT).

The data contains information on the numbers of people waiting for treatment and performance against a range of key operational standards.

Source: Department of Health Cancer Waiting Times Database

From February 2021, data is only published for the suspected cancer pathway. Targets for the urgent and not via the urgent pathway have ceased and no new data will be collected or published for these pathways. The patients shown here are those treated via the non urgent route. The national target for these patients is: at least 98 per cent of patients newly diagnosed with cancer, not via the urgent route will start definitive treatment within 31 days of diagnosis (regardless of the referral route). From 1st April 2019 health service provision for residents of Bridgend local authority moved from Abertawe Bro Morgannwg to Cwm Taf. For more information see the joint statement from Cwm Taf and Abertawe Bro Morgannwg University Health Boards (see weblinks). The health board names have changed with Cwm Taf University Health Board becoming Cwm Taf Morgannwg University Health Board and Abertawe Bro Morgannwg University Health Board becoming Swansea Bay University Health Board. A link to the statement from the minister for health and social service can be found in the weblinks section.

One-year net survival for each cancer site, by whether each waiting time target was met or not, England, 2009–13.

BackgroundMost women with breast cancer in Ethiopia are diagnosed at an advanced stage of the disease, but the reasons for this have not been systematically investigated. This study, therefore, aimed to explore the main reasons for diagnosis of advanced stage breast cancer from the perspective of patients, family members, and health care providers.MethodsA qualitative study with in-depth interviews was conducted with 23 selected participants at Tikur Anbessa Specialized Hospital, Oncology Clinic using a semi-structured interview guide. These participants were 13 breast cancer patients, 5 family members, and 5 health care providers. Data were transcribed into English, coded and analyzed using thematic analysis.ResultsAwareness about the causes, risk, initial symptoms, early detection methods, and treatment of breast cancer were uncommon, and misconceptions about the disease prevailed among breast cancer patients and family members. There was a sense of hopelessness and uncertainty about the effectiveness of conventional medicine amongst patients and family members. Consequently, performing spiritual acts (using holy water) or seeking care from traditional healers recurred amongst the interviewees. Not taking initial symptoms of breast cancer seriously by the patients, reliance on traditional medicines, competing priorities, financial hardship, older age, fear of diagnosis of cancer, and weak health systems (e.g., delay in referral and long waiting period for consultation) were noted as the main contributors to late diagnosis. In contrast, persuasion by family members and friends, higher educational attainment, and prior experience of neighboring women with breast cancer were mentioned to be facilitators of early diagnosis of breast cancer.ConclusionsThe causes of late diagnosis of breast cancer in Ethiopia are multi-factorial and include individual, cultural, and health system factors. Interventions targeting these factors could alleviate the misconceptions and knowledge gap about breast cancer in the community, and shorten waiting time between symptom recognition and diagnosis of breast cancer.

While a publicly available benchmark dataset provides a base for the development of new algorithms and comparison of results, hospital-based data collected from the real-world clinical setup is also very important in automated AI-based medical research likewise in disease diagnosis or categorization of predicted disease for tissue level staging or any class identification as per standard protocol so that the developed algorithm works with as much accuracy as possible in the regional context. The repository supports research work related to image segmentation and final classification for a complete decision support system. Liquid based cytology is one of the cervical screening tests. The repository consists of total 963 images sub-divided into four sets of images representing the four classes of pre-cancerous and cancerous lesions of cervical cancer as per standards under The Bethesda System. The pap smear images were captured in 40x magnification using Leica ICC50 HD microscope which is collected and prepared using the liquid-based cytology technique from 460 patients. Microscopic investigation of abnormal changes in cell-level enables detection of malignancy or pre-malignant characteristics. This procedure is time-consuming and subject to inter or intra-observer variability which is why computer-assisted diagnosis can improve the overall disease diagnosis time period to proceed with rapid treatment and therapy which can limit late diagnosis of cervical cancer.

Cervical cancer is a prevalent disease among women, especially in low- and middle-income countries (LMICs), where most deaths occur. Integrating cervical cancer screening services into healthcare facilities is essential in combating the disease. Thus, this review aims to map evidence related to integrating cervical cancer screening into existing primary care services and identify associated barriers and facilitators in LMICs. The scoping review employed a five-step framework as proposed by Arksey and O’Malley. Five databases (MEDLINE, Maternity Infant Care, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were systematically searched. Data were extracted, charted, synthesized, and summarised. A total of 28 original articles conducted in LMICs from 2000 to 2023 were included. Thirty-nine percent of the reviewed studies showed that cervical cancer screening (CCS) was integrated into HIV clinics. The rest of the papers revealed that CCS was integrated into existing reproductive and sexual health clinics, maternal and child health, family planning, well-baby clinics, maternal health clinics, gynecology outpatient departments, and sexually transmitted infections clinics. The cost-effectiveness of integrated services, promotion, and international initiatives were identified as facilitators while resource scarcity, lack of skilled staff, high client loads, lack of preventive oncology policy, territorial disputes, and lack of national guidelines were identified as barriers to the services. The evidence suggests that CCS can be integrated into healthcare facilities in LMICs, in various primary care services, including HIV clinics, reproductive and sexual health clinics, well-baby clinics, maternal health clinics, and gynecology OPDs. However, barriers include limited health system capacity, workload, waiting times, and lack of coordination. Addressing these gaps could strengthen the successful integration of CCS into primary care services and improve cervical cancer prevention and treatment outcomes.

Key findings on facilitators and barriers of integrated cervical cancer screening service in LMICs.