Evaluation | Right Decisions

The University of Strathclyde was commissioned to evaluate Scotland's first Rapid Cancer Diagnostic Services (RCDSs) to better understand their role in detecting cancer and to ensure optimal components are embedded in future models.

An interim report was published in November 2022. The final report of the Evaluation of Rapid Cancer Diagnostic Services was published in February 2024 on the University of Strathclyde website.

A summary of the evaluation report focuses on the high-level findings and optimal components of the Rapid Cancer Diagnostic Services.

Highlights from the two-year evaluation period include:

3,616 RCDS referrals received and 2,489 (approximately 69%) accepted. The remainder of referrals were largely either redirected to site-specific cancer pathways (approximately 15%) or did not progress onto the RCDS pathway as they didn’t meet referral criteria (approximately 12%)
The conversion rate from RCDS referral to cancer was 11.9% (to note: the Scottish Referral Guidelines (SRG) for Suspected Cancer is set at a 3% threshold)
The overall median time from RCDS referral to outcome was 14 days
CT scanning was the most frequent diagnostic test performed
A range of cancer types were diagnosed. Lung and Hepato-Pancreato-Biliary (HPB) were the two most commonly found
The overall median time from RCDS referral to cancer treatment was 62 days
Unexplained weight loss was the most common symptom. Weight loss was distributed similarly between cancer and non-cancer diagnoses whilst ‘unexpected lab results,’ ‘General Practitioner gut feeling’ and ‘nausea/appetite loss’ were found to be noticeably more common in patients diagnosed with cancer
Cognitive impairment was the only co-morbidity with a positive correlation to a cancer diagnosis
In line with previous research undertaken by NHS Wales, the mean cost per RCDS patient was £650. This compares favorably with NHS Wales’ analysis who found a cost of £646.18 per patient.
The RCDS was compared to a general surgical clinic (the assumed default if no RCDS was available) for NHS Fife and NHS Dumfries and Galloway. This showed that the RCDS was cost effective while being significantly quicker than the estimated time to diagnosis in a general surgical clinic (11.4 – 13.6 days compared to 77.5 - 78.7 days respectively).