Most suspected cancers 'referred after first GP visit'

GP Cancer Research UK said there was more work to be done on early diagnosis

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More than 80% of patients with suspected cancer in England are referred by their GP after just one or two consultations, a study suggests.

Data from more than 13,000 cancer patients shows more than half were referred to a specialist after the first trip to the doctor.

Harder-to-spot cancers, such as lung cancer, took longer to identify.

Cancer Research UK welcomed the figures, but said there was more work to be done on early diagnosis.

Much work has been done on improving early diagnosis in the past decade, including awareness campaigns, National Institute for Health and Clinical Excellence (NICE) guidelines on the symptoms for suspected cancer, and targets to fast-track referrals.

Late diagnosis and treatment of cancers has been highlighted as one reason behind poor cancer survival rates in the UK compared with other countries.

The study showed that work was still needed on some cancers that are harder to spot. About a third of lung and stomach cancer patients needed three or more consultations before they were referred to a specialist.

Start Quote

We now understand the typical symptoms of some cancers, like breast and melanoma, very well and that helps doctors to spot them quickly”

End Quote Dr Georgios Lyratzopoulos Researcher

Study author Dr Georgios Lyratzopoulos, from the Cambridge Centre for Health Services Research, said the results suggested progress was being made.

"We now understand the typical symptoms of some cancers, like breast and melanoma, very well and that helps doctors to spot them quickly.

"Other cancers have less typical symptoms, making them more difficult to recognise straight away.

"Not suspecting cancer early enough can be stressful for patients and their relatives so understanding the symptoms of these cancers better is where we need to be making greater research efforts to help spot the disease earlier."

Prompt referral

Prof Greg Rubin, the clinical lead for cancer at the Royal College of GPs and co-author of the study, said the results showed most patients were referred quickly but there was a significant minority who had a few trips to the GP before suspicion was raised.

"NICE referral guidelines have helped people with classic symptoms to be seen more quickly but, for patients with less typical symptoms, the decision to refer isn't always as simple," he said.

Prof Rubin said the results, in the British Journal of Cancer, showed GPs now needed to think about smarter ways of picking up hard-to-spot cancers sooner.

Easier access to diagnostic tests was one way, but the Department of Health was also trialling decision-making tools to help GPs spot cancer when patients presented with multiple symptoms, he said.

"Not all cancers should be treated the same, we need to get more selective about where we direct our efforts", he added.

Sara Hiom, early diagnosis director at Cancer Research UK, said the findings were encouraging but there was still room for improvement.

"Progress is clearly being made but one in five people have to make more than two visits to their GP, although it's not surprising that this is usually for those cancers that are harder to spot," she said.

She added that it was important patients acted on any persistent health changes that concerned them and had the confidence to go back to their GP if problems did not clear up.

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