Cancer Waiting Time Guidance Update
The Cancer Waiting Time Guidance is being updated to include all malignant brain/CNS tumors, irrespective of WHO grade, with recommendations for recording grade 1 and 2 tumors as cancer patients.
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Presentation Transcript
Cancer Waiting Time Guidance Update Brain and CNS Cancer Clinical Advisory Group Wednesday 17thMay 2023
Guidance update Currently, Cancer Waiting Times Guidance specifies that for patients with brain/CNS tumours, only those with tumours of WHO grade 3 and 4 are applicable to the standards. From July 1st, the guidance is being extended to cover all malignant tumours of the brain and CNS, regardless of WHO grade. Elsewhere in the guidance the term all invasive tumours is used.
Advice required To define which grade 1 and 2 tumours should be included Any changes to how we record these patients will have wider impacts. Patients who are classified as malignant grade 1 or 2 will have to be recorded as a C code . As a result they will receive communications addressing them as a cancer patient and there may be implications for them in terms of insurance etc. As far as we can ascertain, patients with grade 1 and 2 tumours are treated to clinically appropriate timescales and we re not aware of any inappropriate delays i.e. there is nothing to suggest they are being disadvantaged by their classification. Therefore the risks of reclassifying how we record such patients likely outweigh any benefits for most patients. These changes do not affect the clinical coding of patients on PAS systems, only that on cancer systems.
Options Option 1: All brain/CNS tumours of grade 1 and 2 are recorded as cancers Option 2: Brain/CNS tumours of grade 1 and 2 are recorded as cancer only if clinic letters record that the word malignant , invasive or cancer was used to describe the tumour to the patient, and the tumour has not been described to the patient as benign Option 3: Brain/CNS tumours of grade 1 and 2 are recorded as cancer only if they are of the following specified cell types: [CAG please list relevant types e.g. glioblastoma] Alternative option?
Recommended option The recommended option is option 2 as it aligns most closely with the guidance, is simple to understand, and is least likely to cause any unintended negative impacts on patients. If there are any specific tumours that would be an exception and should always/never be considered a cancer please specify these. The guidance specifies that Von Hippel-Landau syndrome is never applicable.
