Abstract

Background: This study aimed to evaluate the direct‐to‐test computed tomography (CT) scan pathway for primary care for the investigation of patients with non‐specific and serious symptoms (SNSS) that may be related to a diagnosis of underlying cancer. Methods: We evaluated all patients referred to the Sunderland Serious Non‐Specific Symptoms pathway directly to the CT scan pathway between December 2017 and June 2019 to assess the rate of SNSP, cancer diagnoses, frequency of benign conditions, and effectiveness of the service. Patients over 18 with non‐specific symptoms including unexplained weight loss, recent or progressive pain of unknown aetiology, severe constitutional symptoms or other symptoms that made the general practitioner (GP) to be suspicious of malignancy were offered rapid access contrast‐enhanced CT scanning of the thorax, abdomen, and pelvis. Results: A total of 411 patients were referred through the GP CT pathway. Of these 411 patients, 46 were diagnosed with cancer, whilst 76 were diagnosed with an incidental finding. Twelve different cancers were diagnosed in total, with an average time to diagnosis of 14 days. Of the cancer diagnoses, just over a quarter were diagnosed at Stage 1. Conclusions: The SNSS pathway is a streamlined GP direct access CT service for patients with serious but non‐specific symptoms and has similar aims to the Accelerate, Coordinate, and Evaluation (ACE) Wave 2 pathways, which were funded by Cancer Research UK. The SNSS pathway was successful in reducing the time from the presentation of symptoms in primary care to a definitive diagnosis for patients with non‐specific symptoms and has the potential to increase the proportion of cancers diagnosed at an early stage. As a direct‐to‐test pathway, the cancer conversion rate of 11% was higher than many other similar SNSS paths reported in the literature.