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QI Project: Are GPs meeting the Criteria for Requesting CT Pancreas scans in Suspected Pancreatic Malignancy?H. Elbeltagi and M. Abhyankar.St Helens & Knowsley NHS Trust Background Pancreatic cancer is the tenth most common cancer in the UK, with an associated 5-year survival of 9%1,2. This poor prognosis has been attributed to presentation in advanced disease. NICE guidance (2015)3 posed to increase access to diagnostic testing in the community and includes direct access to GPs to CT Pancreas scans, where there is suspicion of pancreatic malignancy. The criteria for this include age over 60 with weight loss and either: diarrhoea, back pain, abdominal pain, nausea, vomiting, constipation, or new-onset diabetes. The aim of this project was to assess if CT Pancreas requests by GPs meet NICE guidance, where the target for meeting criteria is 100%.MethodsDirect CT pancreas requested between January 2019 to January 2020 were evaluated. Clinical details were reviewed to determine indication for the CT request. CT scans performed after initial ultrasound scan (USS) were excluded.Results A total of 69 scans were reviewed. 24 patients had initial USS and two scans requested by secondary care providers were excluded. Forty direct CT Pancreas requests were reviewed. Only 10% of GP requests met NICE guidance criteria for CT Pancreas. Discussion There are implications on resource management, with an estimated surplus annual cost of ?4320, and potentially unnecessary radiation exposure with 90% of direct CT pancreas requests not meeting NICE guidelines. These findings were presented locally and a proforma for GP requests will be trialled. Future work will disseminate these findings in local CCG meetings to determine effective interventions and re-evaluate their impact. ReferencesP. Rawla et al. Epidemiology of Pancreatic Cancer: Global Trends, Etiology and Risk Factors. World J Oncol; 2019 accessed 10/11/20 Cancer Research UK. Pancreatic Cancer Statistics. accessed 28/10/20 Suspected cancer: recognition and referral NICE Guidelines 2015. Updated Sept 2020 accessed 28/10/20Word Count: 248 ................
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