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<p>The Routes to Diagnosis study defines a methodology by which the route the patient
follows to the point of diagnosis can be categorised, in order to examine demographic,
organisational, service and personal reasons for delayed diagnosis.</p><p> </p><p>
</p><p> </p><p>Administrative Hospital Episode Statistics data are combined with cancer
waiting times data, data from the cancer screening programmes and cancer registration
data from the National Cancer Data Repository.</p><p> </p><p> </p><p> </p><p>Using
these datasets every case of cancer registered in England which was diagnosed in 2006-2010
is categorised into one of eight ‘Routes to Diagnosis’.</p><p> </p><p> </p><p> </p><p>The
methodology is described in detail in the British Journal of Cancer article <em>Routes
to Diagnosis for cancer - Determining the patient journey using multiple routine datasets</em>,
which can be found at the following link and is also attached.</p><p> </p><p> </p><p>
</p><p>http://www.nature.com/bjc/journal/v107/n8/full/bjc2012408a.html</p><p> </p><p>
</p><p> </p><p>Emergency presentations are defined as “an emergency route via A&E,
emergency GP referral, emergency transfer, emergency admission or attendance.” More
detail can be found in the attached technical document.</p><p> </p><p> </p><p> </p><p>Data
on all malignant neoplasms (excluding non-melanoma skin cancer) and pancreatic cancer
was taken from the “Routes to diagnosis 2006-2010 workbook (a)” – this can also be
found in the attached article.</p><p> </p><p> </p><p> </p><p>The Emergency Presentation
Route is the principle route to diagnosis for patients with pancreatic cancer. This
reflects the lack of easily recognisable symptoms of early disease, with advanced
disease often presenting with the acute onset of jaundice.</p><p> </p><p> </p><p>
</p><p>The percentage of emergency presentations ranges from 3% for melanoma to 63%
for acute lymphoblastic leukaemia.</p><p> </p><p> </p><p> </p><p>Table 1: Percentage
of diagnoses by emergency presentation route, England, persons, 2006-2010</p><p> </p><table><tbody><tr><td>
</td><td><p>Number of cases</p></td><td><p>Number of cases by emergency presentation
route</p></td><td><p>Percentage by emergency presentation route</p></td></tr><tr><td><p>
</p></td><td><p>a</p></td><td><p>b</p></td><td><p>(b/a)x100</p></td></tr><tr><td><p>All
malignant neoplasms</p><p>(excl. non-melanoma skin cancer)</p></td><td><p>1,272,584</p></td><td><p>291,391</p></td><td><p>23%</p></td></tr><tr><td><p>Pancreas</p></td><td><p>34,012</p></td><td><p>16,460</p></td><td><p>48%</p></td></tr></tbody></table><p>
</p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p>
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