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CHANGING REFERRAL PATTERNS FOR SARCOMA PATIENTS IN THE NORTHERN & YORKSHIRE REGION



Abstract

Introduction: Sarcomas are best treated in designated treatment centres. A previous study identified the delays in referral patterns for the years 1999–2000 in Northern and Yorkshire region. The aim of this study was to identify the changes in referral pathways of all non-gynaecological sarcoma patients in view of the NICE guidelines.

Methods: Anonymous data for all non-gynaecological sarcoma patients from year 2000 – 2004 was obtained from the Northern & Yorkshire Cancer Registry.

Results: 1180 of 1430 cases registered in three cancer networks, were selected. The Northern Cancer Network catered to 532 patients. 86.2% of all patients were treated in a designated sarcoma centre compared to 59.8% in the previous study. Of the 504 patients whose dates of first report are available, 39 patients were referred within 2 weeks. 626 of 1180 (53%) patients were diagnosed within two weeks of attending the first hospital. Of the 948 referred to the second hospital, 195 (20.5%) were seen within two weeks of attendance at the first hospital, with an average 56 and median of 38 days. The median age for those referred and otherwise was 55. Of the 631 referred to a third hospital, 187 (29.6%) were seen within two weeks, (average 45 days). The number of patients (Range 1 – 307) seen in each specialty and time taken for referral (range 14 to 127 days) were tallied to denote their efficiencies.

Conclusions: There was a statistically significant increase in referral rates to specialist centres. Age had no influence in referrals, contrary to the previous study. Time delays within specialties show an unchanged trend, with a few exceptions. Further studies into the actual events are needed to unmask the deficient areas.

Correspondence should be addressed to BOOS c/o British Orthopaedic Association, 35-43 Lincoln’s Inn Fields, London WC2A 3PE, England