Diagnosis

Our aim is to optimize the diagnostic process for breast and other high prevalence cancer in primary care by enhancing coordination of care and reducing inefficiencies.

Although emphasis has been placed on the development and optimization of screening programs, over 90% of all cancer diagnoses, and over 50% of breast cancer diagnoses are made because of symptoms.

Timely diagnosis of suspected cancer is important for three reasons:

  1. Cancer stage at diagnosis is highly correlated with eventual patient outcomes.
  2. More timely diagnosis may alleviate the psychological distress felt by patients and their families during this period.
  3. Diagnosing cancer in primary care is an important patient safety issue.

Making a cancer diagnosis in primary care can be difficult due to the diversity of clinical presentations, both within and between cancer types, as well as the significant overlap of cancer symptoms with benign conditions.

As 85% of all cancer patients present first to primary care, research focused on optimizing the diagnostic process in that setting is important. Little is known in Canada about the processes of care leading to cancer diagnosis, but diagnostic delays and inefficiencies at arriving at a cancer diagnosis are known to be problematic.

The goal for the CanIMPACT team is to better understand the diagnostic interval in cancer and factors associated with a timely diagnosis, effective diagnostic paths in primary care, and subgroups at risk for delayed diagnosis.

Outcomes that will be evaluated include diagnostic duration, stage at diagnosis, efficiency and cost of the peri-diagnostic interval. Efficiency will be measured based on consistency of care patterns with expected care as defined by clinician experts on this team. We are studying inter- and intra-provincial variations as they reflect new primary care team practices and Diagnostic Assessment Programs introduced in several provinces. Through these comparisons we will determine quality by identifying the optimal healthcare conditions leading to timely diagnoses and interventions that might address care gaps for breast cancer patients. CanIMPACT is starting with breast cancer to standardize methods across several provinces. We will then study other high prevalence cancers (such as colorectal cancer), if time and resources allow.