Outcomes in urological cancer are strongly influenced by route to diagnosis

Most patients present to their GP with the first symptoms of cancer, but there are other routes of presentation including emergency and referral from another consultant. NCRAS has identified a route for the large majority of patients. The two week wait route is commonest for bladder and testis cancer. In all types of urological cancer, patients who present as an emergency have much worse survival than those who are referred by the 2 week wait. It is more common for the elderly and deprived patients to present as an emergency. We do not have good staging data for this cohort of patients but it is likely that these emergency patients are presenting with incurable disease.