Routes from diagnosis

What is Routes from Diagnosis?

Routes from Diagnosis is a retrospective analysis of almost 85,000 cancer patients’ interactions with NHS England over seven years. It’s the richest picture yet of people living with cancer. It combines two data sets with clinical insight to map the journeys people with cancer followed and the health outcomes they experienced.

Turning information about interactions with the healthcare system into usable intelligence involved a landmark linking of two existing data sets – the National Cancer Data Repository (NCDR) and Inpatient Hospital Episode Statistics (HES). Routes from Diagnosis shows that, with the technology and data already available to the NHS, it is possible to understand cancer journeys in an unprecedented level of detail.

Key findings

  • Surviving cancer doesn’t necessarily mean living well
    We know many people survive breast and prostate cancers. But Routes from Diagnosis reveals that while 70% of breast cancer patients survive their cancer, only 1 in 5 survived for at least seven years in good health (with no recurrence, other cancers or other conditions).
  • Multiple health conditions are the norm, not the exception
    The analysis reveals that 2 in 3 people with cancer are admitted to hospital for conditions other than their cancer.
  • There is huge variation in health outcomes between cancer types, and in people with the same cancer type
    To put it simply, 'one size does not fit all'. This knowledge informed Macmillan’s testing of ‘stratified care pathways’, in which people receive personalised care after cancer treatment according to their individual needs.
  • The best outcomes do not necessarily cost more
    Routes from Diagnosis suggests improving outcomes for patients could save the system money. The analysis reveals how the rate of cancer diagnoses affects the healthcare system – for example, the length of time patients spent in hospital, when they accessed a service, and the cost. The highest costs were not associated with long-term survival, but with people who survived in the medium term, experienced complications or secondary cancers, and needed more care after treatment.