Abstract
Aim: To describe referral pathways and assess delays in order to inform targeting of educational initiatives.
Methods: Anonymised data on all patients with non-gynaecological sarcoma over 2 years (1999–2000), was obtained from the Northern & Yorkshire Cancer Registry.
Results: 362 cases were registered (29 per million). Patients were referred to a maximum of three hospitals. Of 86 managed solely at the first hospital, 13 were treated at a specialist centre. 225 (59.8%) eventually reached a sarcoma specialist centre. Those referred for further treatment were younger compared to those managed at the initial hospital (median age 55–59 vs 65–69 years) p< 0.01, and were symptomatic for a shorter period (292 vs 419 days, NS). Average time between attendance at first and second hospital was 52 days (median 34, range 0–678 days) and between second and third hospitals was 77 days (median 35, range 0–414 days). Onward average referral time by specialty varied from 5 to 93 days.
Conclusion: Evidence suggests that sarcoma treatment is best undertaken by specialist multi-disciplinary teams. However, less than 60% of patients regionally access specialist management, and many experience considerably delay in the referral pathway. Patients referred on from the initial treating hospital tend to be younger and may have had shorter duration of symptoms. Further work is needed to quantify referral delays in primary care. Future guidelines may therefore be usefully targeted both at primary and secondary care.
The abstracts were prepared by Mr Roger Tillman. Correspondence should be addressed to BOOS at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN
