Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of the potential effect of the new NICE Referral Guidelines for Suspected Cancer on the number of patients referred for CT scans each year; and if he will make a statement.

Early diagnosis of cancer is a major priority in helping us to improve cancer survival.

The National Institute for Health and Care Excellence (NICE) updated and published the guideline Suspected cancer: recognition and referral on 23 June 2015, to ensure that it reflects latest evidence and can continue to support general practitioners to identify patients, including those with symptoms of suspected pancreatic cancer, and urgently refer them as appropriate. We know that the earlier cancer is diagnosed, the better the chances of a successful outcome.

The updated guideline makes the following recommendation for suspected pancreatic cancer:

- Refer people using a suspected cancer pathway referral (for an appointment within two weeks) for pancreatic cancer if they are aged 40 and over and have jaundice (new in 2015).

- Consider an urgent direct access computerised tomography (CT) scan (to be performed within two weeks), or an urgent ultrasound scan if CT is not available, to assess for pancreatic cancer in people aged 60 and over with weight loss and any of the following…

diarrhoea;

back pain;

abdominal pain;

nausea;

vomiting;

constipation; and

new‑onset diabetes (new in 2015).

The Guideline Development Group noted in a published costing statement that the recommendation for an urgent CT scan is likely to result in a cost increase because of an increased number of CT scans performed. They noted that this cost increase is likely to be counteracted by a cost saving from an optimised diagnostic process that will see an increase in the number of patients being referred to the right clinic after an abnormal CT scan. NICE has published a costing tool alongside its updated guidance on suspected cancer that National Health Service commissioners can use to estimate the resource impact of implementation of the guidance locally. The costing statement, tool and further information are available at:

www.nice.org.uk/guidance/ng12/resources

More generally, the potential effect of the guideline is being examined by the Independent Cancer Taskforce. The Taskforce expects to publish its report this summer.