Diagnosis and treatment

The Cancer Alliance has a large programme of work to:

  • support the operational delivery of cancer services at local trusts
  • deliver and support transformation of cancer services and provide a system leadership working on behalf of the north central London integrated care system
  • provide oversight and to support organisations to work together effectively
  • support the sector to work better together, through our clinical and operational network groups: reducing variation in care and encouraging innovation.

Key projects

Rapid Diagnostic Centres - vague symptoms pathway

Rapid Diagnostic Centres (RDCs) offer a diagnostic pathway for all patients with non-specific symptoms that could indicate cancer. This patient cohort does not necessarily fit the criteria for a referral onto a tumour specific suspected cancer pathway. There is a Rapid Diagnostic Centre at University College Hospital, North Middlesex Hospital and at the Royal Free Hospital.

Rapid Diagnostic Centres provide:

  • one-stop service where possible
  • consultant-led triage process that enhances the speed and efficiency of pathway
  • clear diagnosis or onward management plan for patients, in addition to tests that exclude or identify cancer
  • effective communication between primary and secondary care
  • enhanced support from clinicians, clinical nurse specialists and care navigators
  • reduced need for GPs to make multiple cancer referrals when a cancer of unknown origin is suspected

Information is available for GPs about how, when clinically appropriate, to request tests for their patients at a RDC, rather than through the two-week wait referral route.

Front entrance of North Middlesex Hospital

Transforming bowel cancer diagnosis

The vast majority of bowel cancers (also known as colorectal cancer) are diagnosed at a late stage which is why it is the second biggest cancer killer in the UK. The Cancer Alliance is supporting a range of projects that will enable earlier diagnosis and better bowel cancer outcomes and potentially stem the increasing need for colonoscopy resources.

Faecal Immunochemical Test (FIT)

FIT is a cheap and non-invasive test that detects hidden blood in a stool sample that could be suggestive of bowel cancer. FIT is the primary test in the NHS Bowel Cancer Screening Programme. It is aimed at individuals without symptoms but is also a very effective triage test for patients with suspicious lower abdominal symptoms. FIT can also be used to guide how the care of individuals with symptoms is managed.

FIT in north central London

The FIT test is being rolled out in phases across north central London. This is based on evidence from one of the largest FIT research studies which was led by the North Central London Cancer Alliance and focused on using FIT with high risk symptomatic patients. The study demonstrated that using FIT is nearly four times more effective in identifying bowel cancer than symptoms alone. It also showed that by using FIT up to 80% of patients could avoid more invasive investigations to exclude bowel cancer.

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