Impact of straight to test pathways on time to diagnosis in oesophageal and gastric cancer

This study aimed to evaluate the impact of a straight to test pathway (STTP) on time to diagnosis for upper gastrointestinal (UGI) cancer. Six hospitals in the East Midlands, UK, introduced a pathway which enabled general practitioners (GPs) to refer patients with suspected UGI cancers for immediate investigation, without needing to see a hospital specialist first. Time from referral to diagnosis for 340 patients following the STTP pathway was compared to 495 patients following the traditional route. Those following the STTP route saved a mean of 7 days from referral to treatment, and a mean of 16 days from referral to diagnosis, when compared to the traditional pathway. The number of diagnostic tests performed using STTP or usual pathway were similar. Findings from this study indicate the STTP approach is feasible, and resulted in an overall reduction of one week from referral to treatment for UGI cancer. Further large-scale trials are required to assess the impact on cancer outcomes.

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