National Cancer Diagnosis Audit (NCDA)

The first audit of cancer diagnoses in primary care in England reported on patients diagnosed with cancer in 2009/10. Following on from that first audit, the National Cancer Diagnosis Audit (NCDA) was set up to collect more recent and in-depth data to further understand the patient pathway through primary care to the diagnosis of cancer.

Over the years the NCDA has been expanded to include information on patients diagnosed with cancer in England, Scotland, Wales and Northern Ireland. The audit undertaken for patients diagnosed in 2018 is also able to assess the impact of the NICE recognition and referral of suspected cancer guidelines that were introduced in 2015.

The NCDA data can be used alongside cancer registration data collected by NDRS, and secondary care health data to further understand pathways to cancer diagnosis.

Participating GP practices, primary care networks, Clinical Commissioning Groups and Cancer Alliances received a report on their own NCDA results, which can be used for quality improvement purposes.

The NCDA is a partnership programme between several organisations. These are:

• NHS England
• Cancer Research UK
• HSC Public Health Agency
• Macmillan Cancer Support
• Northern Ireland Cancer Registry
• Public Health Scotland
• Public Health Wales
• Queen's University Belfast
• Royal College of General Practitioners
• Wales Cancer Network

The image below shows the logos of the NCDA partner organisations

There have been several published outputs using the NCDA data:

1. R Swann and others. Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit. British Journal of General Practice. January 2018: volume 68 issue 666 e63-e72 [viewed on 30 March 2022]*
2. M M Koo and others. Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study. The Lancet Oncology. January 2020: volume 21 number 1 pages 73-79 [viewed on 30 March 2022]

3. C Pearson and others. Cross-sectional study using primary care and cancer registration data to investigate patients with cancer presenting with non-specific symptoms. BMJ Open. January 2020 volume 10(1) e033008

4. R Swann and others. The frequency, nature and impact of GP-assessed avoidable delays in a population-based cohort of cancer patients Cancer Epidemiology. February 2020: volume 64 article 101617 [viewed on 30 March 2022]
5. P Murchie and others. Cancer diagnosis in Scottish primary care: Results from the National Cancer Diagnosis Audit. European Journal of Cancer Care England. May 2020: volume 29 number 3 e13234 [viewed on 30 March 2022]
6. P Murchie and others. Impact of geography on Scottish cancer diagnoses in primary care: Results from a national cancer diagnosis audit. Cancer Epidemiology. June 2020: volume 66 article 101720 [viewed on 30 March 2022]
7. M M Koo and others. The prevalence of chronic conditions in patients diagnosed with one of 29 common and rarer cancers: A cross-sectional study using primary care data. Cancer Epidemiology. December 2020: volume 69 article 101845 [viewed on 30 March 2022]
8. M M Koo and others. Morbidity and measures of the diagnostic process in primary care for patients subsequently diagnosed with cancer. Family Practice. August 2022: volume 39 pages 623-632 [viewed on 30 March 2022]
9. B Cranfield and others: Primary care blood tests before cancer diagnosis: National Cancer Diagnosis Audit data. British Journal of General Practice. February 2023: Volume 73 issue 727 e95-e103.
10. B Cranfield and others. Pre-Referral Primary Care Blood Tests and Symptom Presentation before Cancer Diagnosis: National Cancer Diagnosis Audit Data. Cancers. July 2023: volume 15 (14) 3587
11. R Swann and others. National Cancer Diagnosis Audits for England 2018 versus 2014: a comparative analysis. British Journal of General Practice. August 2023: volume 73 issue 733 e566-e574
12. S Maxwell and others. The impact of rurality on patient experience and diagnostic pathway intervals in Scotland’s cancer patients: Further results from a national cancer diagnosis audit Cancer Epidemiology. October 2023: volume 86 article 102414
13. N Zakkak and others. The presenting symptom signatures of incident cancer: evidence from the English 2018 National Cancer Diagnosis Audit. British Journal of Cancer. December 2023: volume 103 297-307
14. R Swann and others. Predictors and consequences of different pathways to emergency diagnosis of cancer in England: Evidence from linked national audit and cancer registration data Cancer Epidemiology. October 2024: volume 92 article 102607
15. S Merriell and others. Factors affecting prostate cancer detection through asympomatic PSA testing in primary care in England: Evidence from the 2018 National Cancer Diagnosis Audit British Journal of General Practice. 2024: Oct; BJGP.2024.0376

16.  N Akter and others. Variation in the use of primary care-led investigations prior to a cancer diagnosis: analysis of the National Cancer Diagnosis Audit. BMJ Quality & Safety. 2024 Oct 23:bmjqs-2024-017264

* see downloads section for additional information

To find out more about the NCDA visit the NCDA page on the Cancer Research UK website.

For any general enquiries about the NCDA please email [email protected]