An audit of delays in diagnosis and treatment of lymphoma in district hospitals in the northern region of the United Kingdom

Prompt diagnosis and treatment of malignant disorders is generally regarded as improving outcomes. There is good evidence for this in the most common solid tumours, bronchus, breast and large bowel. It might be expected that delays in diagnosis of lymphoma could affect the outcome of treatment, as well as causing dissatisfaction among patients and relatives. However it would be difficult to obtain definite evidence for this as a randomised trial of delay is an unethical proposition. The recently introduced National Priorities Guidance (NPG) Cancer Targets require that all new patients with suspected cancer should see a specialist within two weeks of referral by their General Practitioner (GP). There is no good evidence to support this requirement in lymphoma, but we decided to audit delays at different stages of the process of diagnosis and initial treatment of lymphoma as a base line to assess current performance, identify possible shortcomings and set achievable standards amenable to further audit.