Priority from the Teenage and Young Adult Cancer PSP

UNCERTAINTY: What factors affect the time to diagnosis and what outcomes are affected?
Overall ranking	This was one of the 20 questions at the workshop that fell outside of the Top 10. These were not ranked in any order of priority
JLA question ID	0060/12
Explanatory note	Pathways to diagnosis have been well described in the adult population. Less clear are the pathways for young people.
Evidence	Lethaby CD, Picton S, Kinsey SE, et alA systematic review of time to diagnosis in children and young adults with cancerArchives of Disease in Childhood 2013;98:349-355. https://adc.bmj.com/content/98/5/349.long The majority of reviewed articles included childhood and teenage populations, with seven papers including patients aged 20 years or over. The conclusions drawn from early diagnosis research in children and young adults to date are far from clear. This review highlights some limitations in this research area. The vast majority of publications lack a theoretical framework and consequently the definitions used for key time intervals and milestones are neither robust nor reproducible.
Health Research Classification System category	Cancer

Extra information provided by this PSP
Original uncertainty examples	What signs and symptoms allow early recognition if sarcoma in young people? ~ What are the routes to diagnosis in TYA with cancer that are amenable to improvement? ~ Why are GPs not picking up signs of cancer in young people? ~ Have we concrete evidence delays impact on survival (worse stage disease more metastatic disease etc)
Submitted by	7 x health professionals ~ 4 x patients ~ 2 x parent/carers ~ 1 x relatives ~ 3 friends

PSP information
PSP unique ID	0060
PSP name	Teenage and Young Adult Cancer
Total number of uncertainties identified by this PSP.	185 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	19 January 2018