Introduction: Sarcomas are best treated in designated treatment centres. A previous study identified the delays in referral patterns for the years 1999–2000 in Northern and Yorkshire region. The aim of this study was to identify the changes in referral pathways of all non-gynaecological sarcoma patients in view of the NICE guidelines.

Methods: Anonymous data for all non-gynaecological sarcoma patients from year 2000 – 2004 was obtained from the Northern & Yorkshire Cancer Registry.

Results: 1180 of 1430 cases registered in three cancer networks, were selected. The Northern Cancer Network catered to 532 patients. 86.2% of all patients were treated in a designated sarcoma centre compared to 59.8% in the previous study. Of the 504 patients whose dates of first report are available, 39 patients were referred within 2 weeks. 626 of 1180 (53%) patients were diagnosed within two weeks of attending the first hospital. Of the 948 referred to the second hospital, 195 (20.5%) were seen within two weeks of attendance at the first hospital, with an average 56 and median of 38 days. The median age for those referred and otherwise was 55. Of the 631 referred to a third hospital, 187 (29.6%) were seen within two weeks, (average 45 days). The number of patients (Range 1 – 307) seen in each specialty and time taken for referral (range 14 to 127 days) were tallied to denote their efficiencies.

Conclusions: There was a statistically significant increase in referral rates to specialist centres. Age had no influence in referrals, contrary to the previous study. Time delays within specialties show an unchanged trend, with a few exceptions. Further studies into the actual events are needed to unmask the deficient areas.

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.