The total number of calls to the CTH between 1st January 2016 and 31st December 2020 was 8397. The median age of callers was 63 (range 17-98) and 59.2% were female. From the data, we observed that, 5463 (65.1%) of calls required the patient to be reviewed in person, whilst 2917 (34.7%) received advice only. During the same time period 6,562 individual patients received SACT in Tayside (Table 1).
Use of Cancer Treatment Helpline
The total number of calls to the CTH has gradually increased year on year, with an increase of 83.6% since 2016 (Table 1). Over the same time period, the number of patients being treated has increased by 15.4%. The number of in-hours calls to the CTH has also increased year on year from 530 in 2016 to 1421 in 2020, which corresponds to an increase in the proportion of calls. In the same time period, the number of OOH calls has remained relatively constant (Table 2).
Year
|
2016
|
2017
|
2018
|
2019
|
2020
|
Number of patients who received SACT
|
1212
|
1254
|
1285
|
1412
|
1399
|
Total Number of Calls
|
1137
|
1433
|
1773
|
1967
|
2087
|
Year on year increase (%)
|
-
|
+26.0%
|
+23.7%
|
+10.9%
|
+6.1%
|
Table 1. Total number of calls to the NHS Tayside CTH between 2016 and 2020. Percentage year on year increase indicates the change from the previous year. SACT – systemic anticancer therapy.
Year
|
Total Calls
|
In-hours
|
Out of hours
|
2016
|
1137
|
530 (46.6%)
|
607 (53.4%)
|
2017
|
1433
|
777 (54.2%)
|
656 (45.8%)
|
2018
|
1773
|
1085 (61.2%)
|
688 (38.8%)
|
2019
|
1963
|
1235 (62.9%)
|
728 (37.1%)
|
2020
|
2053
|
1421 (69.2%)
|
632 (30.9%)
|
Table 2. Number of in-hours and out-of-hours calls from 2016-2020. Percentage expressed as proportion of calls according to individual year.
Analysing the data according to the day of the week, the highest number of calls were observed to on a Monday, with a total of 1903 calls (20%) being logged. There was an annual increase in calls on each weekday while number of calls on weekends remained similar. The majority of calls during the day were received in the morning with the greatest number of Monday morning.
Use of CTH according the age
The median age of patients using the CTH was 63 years (range 17-98). There was an increase in the number of calls across all age groups from 2016-2020. There was no significant difference in median age of patient across the years (Table 3).
Year
|
Median (years)
|
2016
|
63 (23-85)
|
2017
|
64 (17-90)
|
2018
|
63 (21-89)
|
2019
|
62 (18-98)
|
2020
|
64 (18-95)
|
Table 3. Median age (range) of patients who called the CTH from 2016-2020.
Impact of tumour group and regime
In keeping with the incidence of the common cancers, the use of the CTH was greatest in patients with breast, lung and colorectal cancer (Table 4). Most tumour groups had an increase in call number – the exception was prostate cancer.
Tumour group
|
2017
|
2018
|
2019
|
2020
|
Total
|
% change
|
Breast
|
295 (21%)
|
387 (22%)
|
477 (24%)
|
465 (22%)
|
1624 (22%)
|
58%
|
Lung
|
305 (21%)
|
405 (23%)
|
413 (21%)
|
408 (20%)
|
1531 (21%)
|
38%
|
Lower GI
|
167 (12%)
|
240 (14%)
|
264 (13%)
|
276 (13%)
|
947 (13%)
|
65%
|
Gynae
|
191 (13%)
|
183 (10%)
|
220 (11%)
|
203 (10%)
|
797 (11%)
|
6%
|
Upper GI
|
173 (12%)
|
155 (9%)
|
170 (9%)
|
263 (13%)
|
761 (10%)
|
52%
|
Prostate
|
105 (7%)
|
101 (6%)
|
105 (5%)
|
80 (4%)
|
391 (5%)
|
-24%
|
Table 4. Breakdown of CTH use by tumour group from 2017-2020. Only tumour groups with more than 100 calls in 2017 are shown. The percentage (%) change from 2017 to 2020 is recorded. GI – gastrointestinal.
The greatest number of patients were on a form of combination treatment at the time of their call. Between 2017 and 2020, the largest increase in use of the CTH was seen for immunotherapy and other treatments; 215% and 225% increase respectively. Calls related to chemotherapy, tyrosine kinase inhibitor and combination therapy increased by 21%, 41% and 26% respectively.
Call outcome
Of the 8397 patients that have used the CTH between 2016 and 2020 – 41% required review by a healthcare professional only, 24% required review and admission and the remaining 35% were given telephone advice only (Table 5). The majority of cases (85%) were either assessed or advised solely by oncology. Of note, the proportional use of GP services has decreased, while the number of patients being reviewed by oncology has increased by an equal proportion. It is important to note the likely impact of the Covid-19 pandemic on the 2020 data, with an increase in advice and a fall in clinical review.
Year
|
Advice only
|
GP/NHS24
|
Oncology review
|
ED review
|
Admission
|
2016
|
30%
|
15%
|
26%
|
3%
|
27%
|
2017
|
32%
|
12%
|
25%
|
2%
|
29%
|
2018
|
31%
|
10%
|
30%
|
2%
|
27%
|
2019
|
31%
|
11%
|
31%
|
4%
|
22%
|
2020*
|
46%
|
11%
|
20%
|
4%
|
19%
|
Table 5. Outcome of calls to the CTH between 2015-2020. Values expressed as percentage of total calls to nearest whole number. *Covid-19 pandemic.