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GP lack of access to cancer diagnostics partly to blame for late detection, says charity

Nearly half of people with cancer are diagnosed at a late stage, partly because some GPs have less access to primary care diagnostics which may detect cancer, according to a report published by charity Cancer Research UK.

The report found 46% of all cancers diagnosed in England in 2012 were diagnosed at stage three or four of the disease, with lung cancers, non-Hodgkin lymphoma and ovarian cancers the least detected.

The Incisive Health report, based on Public Health England’s National Cancer Intelligence Network data, also found wide variation in timing of diagnosis across the country.

The authors said this was partly down to patients in some areas being less likely to approach their GP about potential symptoms, but also cites problems for GPs in some areas getting hold of necessary diagnostic tests.

The report states: ‘The current variation in stage of diagnosis, together with the variation in the number of patients who report a high number of repeat visits to their GP before receiving an onward referral suggests that some GPs are more successful than others in diagnosing cancer early.

‘There may be a number of explanations for this, including: patients in some practice areas may be able to articulate their signs and symptoms more clearly; some GPs may have a higher threshold of suspicion for cancer than others; there may be differences in access to, and usage of, primary care diagnostics which may detect cancer, such as chest X-rays, blood tests, endoscopy and ultrasound.’

The report’s authors claimed an additional 5,000 people per year could be alive five years after diagnosis if all CCGs brought their performance on early detection up to the highest performing ones.

Achieving this would mean an additional 52,000 people a year identified with early-stage disease, which could save the NHS almost £210m a year in treatment costs, they said.

Lung cancers, non-Hodgkin lymphoma and ovarian cancers tended to be picked up the latest, with only 23-44% of these cancers picked up at stage one or two, whereas 93% of melanomas were diagnosed early, as were 83% of breast cancers and 61% of prostate cancers.

The findings come three years into after the Department of Health (DH) launched its Cancer Strategy - which included a pledge to invest £450 million in giving GPs more direct access to diagnostic tests.

A DH spokesperson said: ‘Early diagnosis saves lives. That is why our Cancer Strategy invested £450m in early diagnosis, including giving GPs better access to diagnostic tests.

‘Cancer survival rates continue to improve but we want to be the best country in Europe for cancer diagnosis and treatment. Last year GPs referred nearly half a million more patients to see a cancer specialist than 2010 and we did a record 1.5 million diagnostic tests.’

Health secretary Jeremy Hunt recently announced plans to provide ‘red flags’ on NHS Choices website to inform people where GP practices had a poor record of early referral for cancer investigations, a move he denied would amount to ‘naming and shaming’ individual GPs.

>>>> Clinical Newswire

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Readers' comments (2)

  • GPs also need support from secondary care colleagues and hospital trusts who need to accept that to pick up more cancer early they will see patients who don't have it. A sarcastic letter back to GPs berating their judgement doesn't help. An experience I have had a couple of times recently. Most recently a 70 year old chap who is always well came with his wife with significant weight loss, loss of appetite, and upper abdominal discomfort. I referred him promptly for an OGD which was normal. The consultant then undermined me to my patient saying he couldn't believe I hadn't done bloods or a cxr prior to referral. The mans wife was concerned and pushed for further tests. He had a CT which showed metastatic colorectal cancer! I suspected cancer, albeit the wrong one, referred him at the first visit under the threat of naming and shaming, and still received criticism of my clinical practice

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  • We should not feel under threat from anyone especially our so called secondary care colleagues and Ceramy Junt. No one wants to miss a cancer, and unless we all turn to defensive medicine and refer, over investigate and over treat anything that comes our way, we can not win. It is already common knowledge the hospitals can not cope with the amount of referrals they receive for suspected cancer so they just needs to shut the huff up.

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