Outcomes in urological cancer are strongly influenced by route to diagnosis

Abstract

Introduction: The Routes to Diagnosis study has recorded data on new cancer diagnoses since 2006. The route to diagnosis of urological cancer influences outcomes and factors including gender, age and deprivation are implicated in affecting the way in which patients present. Materials and methods: Data were obtained from the National Cancer Intelligence Network Routes to Diagnosis study. Every new cancer case is assigned to one of eight routes of diagnosis, seven of which are applicable to urological cancers. Data from 2006 to 2013 are described in this report. Results: Two week wait is the most common route to diagnosis of bladder and testicular cancer compared to prostate, renal and penile malignancy in which routine general practitioner referral was the most common route. Two week wait referrals are associated with the best survival, and emergency presentations with the worst. Emergency presentation increases with advancing age but is also noted to be a significant route to diagnosis in patients less than 50 years. Bladder and renal cancer are more common in men but the route to diagnosis varies with gender. Increasing deprivation increases emergency presentation but has minimal effect on two week wait and routine general practitioner referrals. Conclusion: National data on the impact of route to diagnosis of urological malignancy have been described for the first time. The effect of age and gender on route to diagnosis and consequently cancer outcome has been noted. To enable earlier diagnosis attention must focus on extremes of age, patients with penile cancer and the most deprived patients.