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A National Awareness and Early Diagnosis Initiative (NAEDI) has been established in England as part of the Government's strategy to improve cancer outcomes. One of the early priorities for this initiative has been to assemble the diverse evidence linking late diagnosis with poor survival and avoidable deaths. This supplement brings together new perspectives on existing research in this area together with findings from recently commissioned research. This paper describes a provisional model, the 'NAEDI pathway', for testing hypotheses relating to late diagnosis and its impact. Key findings from other papers in this supplement are also highlighted.

Objective: Within Germany, a significant decrease in avoidable mortality from ischemic heart disease (IHD) has been observed since the early 1990s. The objective of this paper is to identify the specific reasons that have led to the decrease in the number of avoidable deaths from IHD in West and East Germany from 1996 to 2004. Methods: We analyzed the mortality rate from IHD of the male population aged less than 65 years on the regional level of German counties over the 1996–2004 period. Methodologically, after adjusting for a number of health structure variables, the socioeconomic structure of each region, and yearly time trends in avoidable mortality, we accounted for unobservable differences among regions by using a fixed-effect estimator. Results: Our main result reveals that the number of intracardiac catheter facilities, an important diagnostic tool for IHD, significantly accounts for decreases in avoidable mortality from IHD. This is important, as the modernization of the East German health sector included a considerable catching-up process in the number of IC facilities provided relative to West Germany. Conclusion: Our results suggest that the modernization of the East German health sector may have contributed to saving people from premature deaths.

The objective of this paper is to identify selected forces of the decrease in the number of avoidable deaths from ischaemic heart diseases (IHD) inWest and East Germany from 1996 to 2004. Our main result reveals that the number of intracardiac catheter facilities,which are an important diagnostic tool for IHD, do significantly account for decreases in avoidable mortality from IHD.This is important, as the modernization of the East German health sector included a considerable catch-up process in the number of IC facilities provided relative to West Germany.