Press release

Big data driving earlier cancer diagnosis in England

A PHE big data project has helped drive a fall in the proportion of cancer patients diagnosed as an emergency.

2 radiotherapists monitoring a cone beam imaging scan of a patient.

The proportion of cancers diagnosed as an emergency at hospital has decreased. At the same time, the proportion of cancers diagnosed through urgent GP referral with a suspicion of cancer has increased.

The complete Routes to Diagnosis data, which covers more than 2 million patients diagnosed with cancer from 2006 to 2013, has been published by Public Health England (PHE) today (Tuesday 10 November 2015). This publicly available, big data project tells us how people are diagnosed, with associated survival rates, for 56 different cancer sites and is a vital tool to help improve early diagnosis.

In 2006, almost 25% of cancers, 1 in 4, were diagnosed as an emergency. In 2013, this figure had fallen to 20%, or 1 in 5. This is against a rise in the overall cases of cancer.

Rates of survival for cancer patients diagnosed as an emergency are much lower than through other routes.

In cancers with screening programmes, like bowel and cervical, the proportion of those detected by screening, with the associated improved survival rates, have increased compared to 2006.

For a common cancer, like lung, the proportion diagnosed through the urgent GP referral route increased from 22% in 2006 to 28% in 2013, while the proportion diagnosed through emergency presentation fell each year, from 39% in 2006 down to 35% in 2013.

Julia Verne, Head of Clinical Epidemiology, PHE, said:

The latest Routes to Diagnosis data shows a positive trend in how cancer is diagnosed in England. The earlier the better if we are to catch up with comparable European countries.

It is hugely satisfying to see innovative use of big data help improve cancer diagnosis and thus, survival. Routes to Diagnosis has helped inform other work like PHE’s Be Clear on Cancer campaigns, which help people spot symptoms early and PHE’s NHS Screening Programmes.

These improvements in routes to cancer diagnosis follow several years of work across the sector to improve early diagnosis in England and we encourage anyone with an interest, from patients, to charities, to clinicians, to look at the data. Our work however, is not complete; while emergency presentation is declining it still remains high for cancers like liver and pancreas.

Sara Hiom, Cancer Research UK’s director of early diagnosis, said:

It’s encouraging that the proportion of cancers being diagnosed as an emergency is moving in the right direction. But it’s important to highlight that nearly 60,000 people every year are still being diagnosed in this way – and this is far too many people.

We know that if someone is diagnosed as an emergency, their cancer is more likely to be advanced, which often means treatment options are more limited. The earlier cancer is detected, the greater the chances of survival.

This report provides vital insight into how well England is doing at diagnosing cancer, but it’s important that efforts continue to further improve early diagnosis. Far too many cancers are still being picked up at a late stage and this needs to change.

Dominic Stanley

Background information

  1. The full and final Routes to Diagnosis data for every cancer site 2006 to 2013 has been published.
  2. This follows the preliminary report published in September: Routes to Diagnosis 2006 to 2013, preliminary results.
  3. Compared to the European average, cancer survival in England is low. Studies have suggested this difference could be largely due to later diagnosis, by which time cancers are harder to treat and have progressed to a more advanced stage.
  4. This fact led to the development of the National Awareness and Early Diagnosis Initiative (NAEDI). A key piece of this work is the Routes to Diagnosis data.
  5. The National Cancer Intelligence Network (NCIN) in PHE has worked with (partners) Cancer Research UK on the Routes to Diagnosis project since 2007 and it has greatly improved the understanding of where delays arise. NCIN both defined a methodology to determine the route a patient took through the healthcare system before receiving a cancer diagnosis and collects, analyses and publishes the data on it.
  6. The Routes to Diagnosis methodology is described in the preliminary report.
  7. A Route to Diagnosis describes the end point of the pathway a patient follows to a diagnosis of cancer. There are 8 aggregated Routes derived from multiple linked data sets. These include 2 Week Wait (urgent GP referral with a suspicion of cancer) and Emergency Presentation (an emergency Route via A&E, emergency GP referral, emergency transfer, emergency consultant outpatient referral or emergency admission or attendance).
  8. The National Cancer Intelligence Network (NCIN) is part of PHE.
  9. PHE has run several Be Clear on Cancer campaigns for different cancer sites.
  10. For bids, please contact Dominic Stanley at PHE:, telephone 020 7654 8400, out of hours telephone 020 8200 4400.
  11. Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Follow us on Twitter: @PHE_uk and Facebook:
Published 10 November 2015