71660 - Visualization of patient flow in standardized cancer patient pathways, and performance of detecting cancer

Introduction Standardized cancer patient pathways (CPPs) were implemented to improve investigation and diagnostics for patients with symptoms comprising well-founded suspicion of cancer. Our primary aim was to visualize the patient population going through CPPs, in terms of investigation time and various outcomes including cancer diagnoses. A second aim was to examine the performance of cancer detection in CPPs. Method We used data on patients starting in any of 28 CPPs (n=19,204) and patients diagnosed with cancer (n=7,895), in 2018 in Region Skåne in Sweden. The data, deterministically linked on the individual level, covered dates, events, and outcomes of CPPs and diagnoses recorded in the Swedish Cancer Register. A state-transition model was developed to map patients' pathways through the CPPs. The patient flow through the model was visualized. Diagnoses were used to study rates of detected and undetected cancer. Result The visualization shows time of investigation, time to start of treatment, and rates of detected and undetected cancer. In patients whose suspicion of cancer was rejected, 0.8% were later diagnosed with the primarily suspected cancer, 1.0% with other cancer. Among patients not meeting criteria for well-founded suspicion, less than 3% were later diagnosed with cancer, none of which with the primarily suspected cancer. Discussion The visualization provides a useful overview of the patient flow through CPPs and illustrates investigation time, events, and outcomes. The use of CPPs detects cancer efficiently.