The Oxford Cancer Centre at the Churchill Hospital has implemented a new whole-body CT scan referral pathway which investigates patients with 'non-specific but concerning' symptoms - so called 'Low risk, but not no risk'.

The Oxford Suspected CANcer Pathway, or SCAN, has been developed in partnership with the Oxfordshire Clinical Commissioning Group (OCCG), and is part of a joint national programme called ACE - Accelerate, Co-ordinate and Evaluate - from Cancer Research UK, Macmillan and the NHS.

The programme pilots new pathways for patients who currently do not fit into the existing cancer two week wait pathways.

At present, GPs are unable to access rapid investigations such as whole body CT scans for people with 'non-specific' symptoms such as weight loss and tiredness. People frequently make multiple trips to their GP with these symptoms, and often between their GP and the hospital, trying to establish a diagnosis. This delay in diagnosis may have a negative effect on the outcome of their illness, is very stressful and time-consuming for the patient and expensive for the NHS.

The Oxford SCAN project enables patients who fulfil the referral criteria, to be referred directly from their GP to Radiology at the Churchill Hospital. The patient then undergoes a panel of blood tests and a whole body CT scan. This enables both a diagnosis to be made and for patients to begin treatment earlier than is current practice.

"Symptoms such as weight loss, fatigue and abdominal pain may be due to a variety of causes, including cancer, and the Oxford SCAN pathway helps find the cause faster," says Julie-Ann Phillips, Oxford SCAN Pathway Navigator at the Churchill Hospital.

"If cancer is found, the patient is referred to a Multi-Diagnostic Team. If it isn't cancer the patient is reviewed by a senior clinician at a multi-diagnostic clinic to get to the bottom of the symptoms. Previously, these patients wouldn’t have been scanned."

The approach of enabling GPs to refer for whole body CT scans is new for the NHS and aimed at improving access for primary care. People 'with non-specific symptoms, at low risk but not no risk', and over the age of 40 are being included in the Oxford SCAN project. So far, 37 patients have been scanned.

"Of those scanned, we have diagnosed seven people with cancer. In the others we have discovered patients with other issues such as chronic anaemia and Addison's disease", says Mrs Phillips.

"We've had extremely positive feedback. Making a diagnosis earlier or excluding serious disease resulting in less GP and hospital visits, and fewer tests, is good for patients, doctors and the NHS."

The Oxford SCAN pathway is currently available to people in North and West Oxfordshire. The project is due to go county-wide in the autumn of 2017. The data collected from the pathway will enable NHS England to decide whether to roll out the programme across the whole of the country, and be another step to improving cancer survival.