{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:50:33Z","timestamp":1791532233924,"version":"4.3.4"},"reference-count":41,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T00:00:00Z","timestamp":1599177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C8640\/A23385"],"award-info":[{"award-number":["C8640\/A23385"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C18081\/A18180"],"award-info":[{"award-number":["C18081\/A18180"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C56843\/A21550"],"award-info":[{"award-number":["C56843\/A21550"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Cancer Epidemiology"],"published-print":{"date-parts":[[2020,12]]},"DOI":"10.1016\/j.canep.2020.101805","type":"journal-article","created":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T18:18:43Z","timestamp":1599675523000},"page":"101805","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":42,"special_numbering":"C","title":["Trends in time to cancer diagnosis around the period of changing national guidance on referral of symptomatic patients: A serial cross-sectional study using UK electronic healthcare records from 2006\u201317"],"prefix":"10.1016","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-2374","authenticated-orcid":false,"given":"Sarah","family":"Price","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Spencer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Ball","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2873-7421","authenticated-orcid":false,"given":"Georgios","family":"Lyratzopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Mujica-Mota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sal","family":"Stapley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obioha C","family":"Ukoumunne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-1373","authenticated-orcid":false,"given":"Willie","family":"Hamilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.canep.2020.101805_bib0005","series-title":"Achieving World-Class Cancer Outcomes: Taking the Strategy Forward","author":"Independent Cancer Taskforce","year":"2016"},{"key":"10.1016\/j.canep.2020.101805_bib0010","series-title":"Suspected Cancer: Recognition and Referral [NG12]","author":"National Institute for Health and Care Excellence","year":"2015"},{"issue":"1","key":"10.1016\/j.canep.2020.101805_bib0015","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.healthpol.2011.11.001","article-title":"Cancer patient pathways in Denmark as a joint effort between bureaucrats, health professionals and politicians\u2014a national Danish project","volume":"105","author":"Probst","year":"2012","journal-title":"Health Policy"},{"issue":"12","key":"10.1016\/j.canep.2020.101805_bib0020","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1016\/j.healthpol.2016.09.008","article-title":"The 2015 National Cancer Program in Sweden: Introducing standardized care pathways in a decentralized system","volume":"120","author":"Wilkens","year":"2016","journal-title":"Health Policy"},{"key":"10.1016\/j.canep.2020.101805_bib0025","series-title":"Public Health England, Routes to Diagnosis 2006-2013","year":"2015"},{"issue":"12","key":"10.1016\/j.canep.2020.101805_bib0030","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/S1470-2045(15)00205-3","article-title":"The expanding role of primary care in cancer control","volume":"16","author":"Rubin","year":"2015","journal-title":"Lancet Oncol."},{"key":"10.1016\/j.canep.2020.101805_bib0035","series-title":"Referral Guidelines for Suspected Cancer","author":"National Institute for Health and Clinical Excellence","year":"2005"},{"key":"10.1016\/j.canep.2020.101805_bib0040","series-title":"Ovarian Cancer: Initial Recognition and Management","author":"National Institute for Health and Care Excellence","year":"2011"},{"issue":"2","key":"10.1016\/j.canep.2020.101805_bib0045","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.neo.2017.11.005","article-title":"Symptom signatures and diagnostic timeliness in cancer patients: a review of current evidence","volume":"20","author":"Koo","year":"2018","journal-title":"Neoplasia"},{"key":"10.1016\/j.canep.2020.101805_bib0050","series-title":"Northern Ireland Referral Guidance for Suspected Cancer","author":"Department of Health","year":"2012"},{"issue":"1","key":"10.1016\/j.canep.2020.101805_bib0055","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1186\/1471-2407-14-636","article-title":"Cancer suspicion in general practice, urgent referral and time to diagnosis: a population-based GP survey and registry study","volume":"14","author":"Jensen","year":"2014","journal-title":"BMC Cancer"},{"issue":"5","key":"10.1016\/j.canep.2020.101805_bib0060","doi-asserted-by":"crossref","first-page":"e0127717","DOI":"10.1371\/journal.pone.0127717","article-title":"Age and gender variations in cancer diagnostic intervals in 15 cancers: analysis of data from the UK clinical practice research datalink","volume":"10","author":"Din","year":"2015","journal-title":"PLoS One"},{"issue":"3","key":"10.1016\/j.canep.2020.101805_bib0065","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1038\/bjc.2013.791","article-title":"Comparison of cancer diagnostic intervals before and after implementation of NICE guidelines: analysis of data from the UK General Practice Research Database","volume":"110","author":"Neal","year":"2014","journal-title":"Br. J. Cancer"},{"key":"10.1016\/j.canep.2020.101805_bib0070","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1186\/1471-2407-14-636","article-title":"Cancer suspicion in general practice, urgent referral and time to diagnosis: a population-based GP survey and registry study","volume":"14","author":"Jensen","year":"2014","journal-title":"BMC Cancer"},{"issue":"4","key":"10.1016\/j.canep.2020.101805_bib0075","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/j.0887-378X.2004.00325.x","article-title":"Diffusion of innovations in service organizations: systematic review and recommendations","volume":"82","author":"Greenhalgh","year":"2004","journal-title":"Milbank Q."},{"issue":"Suppl","key":"10.1016\/j.canep.2020.101805_bib0080","doi-asserted-by":"crossref","first-page":"S80","DOI":"10.1038\/sj.bjc.6605396","article-title":"The CAPER studies: five case-control studies aimed at identifying and quantifying the risk of cancer in symptomatic primary care patients","volume":"101","author":"Hamilton","year":"2009","journal-title":"Br. J. Cancer"},{"key":"10.1016\/j.canep.2020.101805_bib0085","series-title":"Scottish Referral Guidelines for Suspected Cancer","author":"NHS Scotland","year":"2014"},{"issue":"11","key":"10.1016\/j.canep.2020.101805_bib0090","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-019637","article-title":"Identifying clinical features in primary care electronic health record studies: methods for codelist development","volume":"7","author":"Watson","year":"2017","journal-title":"BMJ Open"},{"issue":"7","key":"10.1016\/j.canep.2020.101805_bib0095","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1038\/bjc.2012.68","article-title":"The Aarhus statement: improving design and reporting of studies on early cancer diagnosis","volume":"106","author":"Weller","year":"2012","journal-title":"Br. J. Cancer"},{"key":"10.1016\/j.canep.2020.101805_bib0100","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2020.113021","article-title":"Measuring the impact of national guidelines: what methods can be used to uncover time-varying effects for healthcare evaluations?","volume":"258","author":"Price","year":"2020","journal-title":"Soc. Sci. Med."},{"issue":"1","key":"10.1016\/j.canep.2020.101805_bib0105","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jeconom.2016.09.011","article-title":"A varying-coefficient panel data model with fixed effects: theory and an application to US commercial banks","volume":"196","author":"Feng","year":"2017","journal-title":"J. Econometr."},{"issue":"4","key":"10.1016\/j.canep.2020.101805_bib0110","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1002\/jae.1261","article-title":"Categorical semiparametric varying-coefficient models","volume":"28","author":"Li","year":"2013","journal-title":"J. Appl. Econometr."},{"issue":"3","key":"10.1016\/j.canep.2020.101805_bib0115","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1093\/ije\/dyv098","article-title":"Data resource profile: Clinical Practice Research Datalink (CPRD)","volume":"44","author":"Herrett","year":"2015","journal-title":"Int. J. Epidemiol."},{"issue":"1","key":"10.1016\/j.canep.2020.101805_bib0120","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ije\/dyz076","article-title":"Data resource profile: National Cancer Registration Dataset in England","volume":"49","author":"Henson","year":"2019","journal-title":"Int. J. Epidemiol."},{"issue":"2","key":"10.1016\/j.canep.2020.101805_bib0125","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1002\/pds.3374","article-title":"Cancer recording and mortality in the General Practice Research Database and linked cancer registries","volume":"22","author":"Boggon","year":"2013","journal-title":"Pharmacoepidemiol. Drug Saf."},{"issue":"5","key":"10.1016\/j.canep.2020.101805_bib0130","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.canep.2012.05.013","article-title":"Validity of cancer diagnosis in a primary care database compared with linked cancer registrations in England. Population-based cohort study","volume":"36","author":"Dregan","year":"2012","journal-title":"Cancer Epidemiol."},{"issue":"308","key":"10.1016\/j.canep.2020.101805_bib0135","article-title":"Diagnostic intervals before and after implementation of cancer patient pathways - a GP survey and registry based comparison of three cohorts of cancer patients","volume":"15","author":"Jensen","year":"2015","journal-title":"BMC Cancer"},{"issue":"5","key":"10.1016\/j.canep.2020.101805_bib0140","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-011664","article-title":"Is omission of free text records a possible source of data loss and bias in Clinical Practice Research Datalink studies? A case\u2013control study","volume":"6","author":"Price","year":"2016","journal-title":"BMJ Open"},{"issue":"659","key":"10.1016\/j.canep.2020.101805_bib0145","doi-asserted-by":"crossref","first-page":"e377","DOI":"10.3399\/bjgp17X690869","article-title":"Emergency diagnosis of cancer and previous general practice consultations: insights from linked patient survey data","volume":"67","author":"Abel","year":"2017","journal-title":"Br. J. Gen. Pract."},{"issue":"9","key":"10.1016\/j.canep.2020.101805_bib0150","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1038\/bjc.2017.71","article-title":"Does emergency presentation of cancer represent poor performance in primary care? Insights from a novel analysis of linked primary and secondary care data","volume":"116","author":"Murchie","year":"2017","journal-title":"Br. J. Cancer"},{"issue":"11","key":"10.1016\/j.canep.2020.101805_bib0155","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-023870","article-title":"Diagnostic routes and time intervals for patients with colorectal cancer in 10 international jurisdictions; findings from a cross-sectional study from the International Cancer Benchmarking Partnership (ICBP)","volume":"8","author":"Weller","year":"2018","journal-title":"BMJ Open"},{"issue":"6","key":"10.1016\/j.canep.2020.101805_bib0160","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1016\/j.canep.2015.06.005","article-title":"Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study","volume":"39","author":"Nadpara","year":"2015","journal-title":"Cancer Epidemiol."},{"issue":"6","key":"10.1016\/j.canep.2020.101805_bib0165","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.jclinepi.2011.12.006","article-title":"Diagnostic interval and mortality in colorectal cancer: U-shaped association demonstrated for three different datasets","volume":"65","author":"T\u00f8rring","year":"2012","journal-title":"J. Clin. Epidemiol."},{"issue":"1","key":"10.1016\/j.canep.2020.101805_bib0170","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/bjc.2017.381","article-title":"Variation in 'fast-track' referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites","volume":"118","author":"Zhou","year":"2018","journal-title":"Br. J. Cancer"},{"issue":"5","key":"10.1016\/j.canep.2020.101805_bib0175","article-title":"Advanced-stage cancer and time to diagnosis: an International Cancer Benchmarking Partnership (ICBP) cross-sectional study","volume":"28","author":"T\u00f8rring","year":"2019","journal-title":"Eur. J. Cancer Care"},{"key":"10.1016\/j.canep.2020.101805_bib0180","series-title":"National Cancer Registration and Analysis Service: Routes to Diagnosis","author":"Public Health England","year":"2019"},{"key":"10.1016\/j.canep.2020.101805_bib0185","series-title":"Rapid Review of Endoscopy Services","author":"NHS Improvement","year":"2012"},{"key":"10.1016\/j.canep.2020.101805_bib0190","series-title":"Scoping the Future: An Evaluation of Endoscopy Capacity Across the NHS in England","author":"Brown","year":"2015"},{"key":"10.1016\/j.canep.2020.101805_bib0195","series-title":"Targeted Screening for Lung Cancer with Low Radiation Dose Computed Tomography","author":"NHS England - National Cancer Programme","year":"2019"},{"key":"10.1016\/j.canep.2020.101805_bib0200","series-title":"Unfinished Business: An Assessment of the National Approach to Improving Cancer Services in England 1995-2015","author":"Richards","year":"2018"},{"issue":"3","key":"10.1016\/j.canep.2020.101805_bib0205","first-page":"e13265","article-title":"Cancer diagnosis and treatment in the COVID-19 era","volume":"29","author":"Weller","year":"2020","journal-title":"Eur. J. Cancer care"}],"container-title":["Cancer Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877782120301399?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877782120301399?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:18:16Z","timestamp":1791530296000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1877782120301399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":41,"alternative-id":["S1877782120301399"],"URL":"https:\/\/doi.org\/10.1016\/j.canep.2020.101805","relation":{},"ISSN":["1877-7821"],"issn-type":[{"value":"1877-7821","type":"print"}],"subject":[],"published":{"date-parts":[[2020,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Trends in time to cancer diagnosis around the period of changing national guidance on referral of symptomatic patients: A serial cross-sectional study using UK electronic healthcare records from 2006\u201317","name":"articletitle","label":"Article Title"},{"value":"Cancer Epidemiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.canep.2020.101805","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"101805"}}