National audit of cancer diagnosis in primary care

The RCGP, Cancer Research UK, Public Health England, NHS England and Macmillan ran an enhancement of the audit in 2016/17 which gathered data on cancers diagnosed in 2014. The initial results of this audit are published in the British Journal of General Practice. To find out more, please visit Cancer Research UK's website.

This National audit of cancer diagnosis in primary care was undertaken in 2009/10 as part of the National Awareness and Early Diagnosis Initiative. It was led by Professor Greg Rubin, with the RCGP, the National Cancer Action Team and the National Cancer Intelligence Network.



The report found that:

  • three quarters (73.2 per cent) of patients visiting their GP were referred to a specialist after only one or two consultations
  • nearly 60 per cent of all patients referred (57.1 per cent) attended secondary care within two weeks

The report also looked at use of investigations and found that some cancer patients, including those with brain, ovarian, pancreatic, liver and kidney cancer, were more likely to have benefitted from better primary care access to diagnostics including

  • chest X-rays
  • non-obstetric ultrasounds
  • GI endoscopies
  • brain MRIs

Overall, rapid access to investigations would have altered the GP's management of the patient in six per cent of cases.

The NCDA found that in 2014:

  • Most patients (72%) first presented at the GP surgery (or had a home visit)
  • 74% of patients were referred to a specialist after only one or two consultations; approximately 52% were referred through the Two Week Wait route
  • Primary care led investigations before referral were used in 45% of all patients
  • For 44% of patients, there was evidence in the clinical record that safety netting had been used

The full publication about the NCDA findings is available at: 


The below template includes the data items captured in the National Cancer Diagnosis Audit and may be used in your own practice if you wish to audit cancer diagnoses.

Note: the template should only be used internally to audit cancers diagnosed before 1 January 2018.

We do not recommend auditing patients diagnosed on or after 1 January 2018 in order not to jeopardise your practice's ability to take part in, and gain learning from, the next official NCDA which will likely audit patients diagnosed from 2018 onwards.

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