Routes to diagnosis (RTD) are defined using an algorithmic approach that describe patients’ care pathways to diagnosis of cancer.
Routes to diagnosis are categorised into eight different routes, consisting of:
-
- Two-week wait (TWW)
- GP referral
- Emergency presentation (EP)
- Inpatient elective
- Screening
- Other outpatient
- Unknown route
- Death certificate only
Key findings:
-
- 39% of patients presented via GP referrals.
- 22.1% presented through TWW.
- 16.1% were Emergency Presentations (EP).
- 15.5% presented through other outpatient appointments.
- Patients with rhabdomyosarcoma were most likely to present acutely with 36.3% presenting as an EP.
- Phyllodes tumours were most likely to present through a TWW.
- There was an increase in patients diagnosed via the TWW pathway (22.1%, compared to 12.5% in 2006-2008¹
You can explore more of the findings in the table below, or access the full paper here.
Figure 1: Route to diagnosis for all soft tissue sarcomas (2013-2017)
Table 1: Proportion of patients by sarcoma subgroup according to routes to diagnosis (2013-2017).
| Soft tissue sarcoma subgroup | Two-Week Wait pathway | GP referral | Emergency presentation | Inpatient elective | Other outpatient | Screening | Unknown route | Death certificate only |
|---|---|---|---|---|---|---|---|---|
| All STS (incl. tumours of intermediate behaviour) | 22.1 | 39 | 16.1 | 2.1 | 15.5 | 0.2 | 4.9 | 0.1 |
| Gastrointestinal stromal tumour | 10.1 | 35.9 | 26.4 | 4 | 21.2 | 0 | 2.3 | 0.1 |
| Leiomyosarcoma | 26.6 | 38.8 | 13.7 | 1.1 | 12.1 | 0 | 7.5 | 0.1 |
| Undifferentiated sarcoma | 31.6 | 39.1 | 11.3 | 1.6 | 11.6 | 0 | 4.7 | 0 |
| Liposarcoma | 28.1 | 41.7 | 9.2 | 1.5 | 15.2 | 0 | 4.4 | 0 |
| Other malignant soft tissue sarcomas | 23.6 | 34.4 | 24 | 1.2 | 12 | 0 | 4.5 | 0.3 |
| Myxoid and other fibroblastic tumours | 38 | 35.6 | 5.5 | 0.7 | 15.3 | 0 | 5 | 0 |
| Soft tissue sarcoma of intermediate behaviour | 5.1 | 58.4 | 6.8 | 2.7 | 20 | 0 | 6.9 | 0 |
| Vascular tumours | 20.9 | 38.4 | 20.7 | 0.8 | 14.5 | 0.8 | 3.8 | 0.1 |
| Dermatofibrosarcoma protuberans | 17.8 | 54.2 | 2.7 | 1.4 | 9 | 0 | 14.9 | 0 |
| Rhabdomyosarcoma | 14 | 24.5 | 36.3 | 5.5 | 16.8 | 0 | 2.9 | 0 |
| Tumours of uncertain differentiation | 21.6 | 34.8 | 16.7 | 3.1 | 18.4 | 0.7 | 4.7 | 0 |
| Synovial sarcoma | 24.4 | 35.8 | 8.1 | 1.3 | 23.4 | 0 | 7.1 | 0 |
| Endometrial stromal tumour | 24.4 | 45.2 | 11.7 | 1.5 | 14.2 | 0 | 3 | 0 |
| Myofibrosarcomas and other fibroblastic sarcomas | 16.1 | 43.5 | 16.1 | 3.1 | 16.1 | 0.3 | 4.9 | 0 |
| Malignant peripheral nerve sheath tumour | 13.1 | 42.6 | 15.9 | 1.9 | 24 | 0 | 2.5 | 0 |
| Phyllodes | 54 | 24.2 | 4.8 | 0.3 | 5.2 | 7.3 | 4.2 | 0 |
*Patients under the age of 15 and over the age of 99 were excluded from analysis. For groups where there is not at least 1 patient in each ICSS age group, outputs cannot be generated.
Abbreviations: N – cohort size; LCI– Lower Confidence Interval; UCI – Upper Confidence Interval
References
- Gerrand, C., Francis, M., Dennis, N., Charman, J., Lawrence, G., Evans, T. and Grimer, R., 2015. Routes to diagnosis for sarcoma–Describing the sarcoma patient journey. European Journal of Surgical Oncology (EJSO), 41(10), pp.1393-1399.
