Objective To evaluate the role of the urgent 2-week referral pathway in facilitating the early diagnosis of childhood cancer.

Design Retrospective case notes review of all children referred via the pathway and all children diagnosed as having cancer via other means over a period of 3½ years (January 2007–July 2010).

Setting District general hospital with a shared care oncology service.

Patients 82 children aged 0–15 years.

Outcome measures Outcomes for children referred via the 2-week urgent referral pathway, including diagnosis, need for further investigations and need for further specialist input.

Results 35 children were referred via the 2-week urgent referral pathway with suspected cancer. Only one of these children had a malignancy. 49% of children required no further investigations and 43% were discharged after the first appointment with no follow-up thought necessary. Over the same time period, 47 children were diagnosed as having cancer via other means.

Conclusion The pickup rate of cancer among children referred via the 2-week urgent referral pathway is extremely low and the vast majority of cancer is diagnosed via different routes.