Are the serious problems in cancer survival partly rooted in gatekeeper principles?

Thank you for this important and interesting paper.¹ Can I ask at what point in the course of the illness and by what criteria cancer was diagnosed? In my practice in Edinburgh, the diagnosis of cancer is based on histological examination of tissue obtained by a specialist. Imagine two patients: one patient in a system without a gatekeeper presents directly to a specialist who takes a biopsy that shows cancer; the patient dies 53 weeks after presentation and is therefore alive at 1 year. The other patient, in my practice, sees me initially and is referred and, 2 weeks later, sees a hospital specialist who takes a biopsy; this second patient dies 53 weeks after presentation to me, that is 51 weeks after seeing the specialist and having cancer diagnosed. Apparently the first patient survives 53 weeks and the second patient 51 weeks. I'd be grateful for a comment on this.