Rapid-access gynecological oncology clinic outcomes in North London, UK.

Bansal, Jassimran K.; Goldrick, Isabelle G.; Manchanda, Ranjit; Olaitan, Adeola

The North London Gynaecological Cancer Network guidelines, based on Department of Health recommendations, state that women with lesions or symptoms suspicious of gynecological cancer should be referred to the rapid-access clinic (RAC) and see a specialist within 2 weeks. The appropriateness and clinical outcomes of these referrals were evaluated and compared with cancers diagnosed from other sources in the same hospital over the same time period. This was a retrospective review of RAC gynecological cancer referrals to University College London Hospital in 2012. Clinical and demographic details were collected from the Clinical Data Repository. Statistics were calculated with MeasuringU software. Among 335 women referred to the RAC, 14 (4.2%) had cancer. Most women had benign pathology (80.6%). This same year, 13 cancers were diagnosed elsewhere, including in the emergency department. A total of 172 referrals did not fulfill the guidelines. The apparent positive predictive value (PPV) for the referrals was 0.042. If appropriately followed, the PPV for guidelines would be 0.091. The apparent PPV of the current referral system for urgent gynecological cancers is low. Greater discretion in primary care and proper use of referral guidelines are required. Avoiding inappropriate referrals can double the PPV, leading to cost savings for the National Health Service.

GYNECOLOGIC cancer; MEDICAL referrals; GUIDELINES; ONCOLOGY; TUMORS; CANCER diagnosis; MEDICAL protocols

Clinical Audit, 2017, Vol 9, p19

1179-2760

Academic Journal

10.2147/CA.S127369