Objective The objective of this systematic review was to assess the scientific basis for methods that might provide earlier cancer diagnosis in persons with symptoms or signs that might indicate cancer. Screening for cancer was not included in this assessment.

Conclusions

• Adding a photograph of suspected skin cancer to the standard referral can shorten the time to the initial evaluation by a specialist department. The management of the patient can also be better planned and resources can be saved.
• Providing information and education to the population can improve knowledge and awareness of cancer, especially if the intervention is personalised and this can be seen up to 2 years after the intervention. Studies with longer follow-up times are lacking.
• We could not determine if providing information and education to health care professionals led to that patients are diagnosed earlier cancer diagnosis or that such interventions had any impact on survival or mortality. The scientific basis was insufficient in this respect.
• Fast-tracks for managing persons with certain defined symptoms that are indicative of cancer can shorten the diagnostic phase by a number of weeks. However, most new cases are discovered as part of routine patient care outside the fast-tracks. There are some indications that the diagnostic time of those in routine care is actually increased when fast-tracks are introduced into the health care system. The risk for such delay for patients in routine care must be addressed when fast-tracks are introduced and evaluated.
• Self-examinations of breasts do not affect breast cancer mortality on a population level but do increase the rate of local diagnostic procedures.
• Cost-effectiveness could not be evaluated for any of the methods because of a lack of information in the literature.