Routes to diagnosis | Sarcoma UK
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Routes to diagnosis

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

  1. 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.

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