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GPs refer most cancers ‘after one or two visits’

More than 80% of patients presenting to their GP with symptomatic cancers are referred after one or two visits, a new study shows.

Data from more than 13,000 cancer patients analysed by the National Audit of Cancer Diagnosis in Primary Care shows that 58% of patients were referred by their GP on the first visit and 25% after two consultations.

Patients who had cancers with more specific symptoms such as breast cancer and melanoma were more likely to be referred after just one or two consults. Cancers with less specific symptoms such as lung cancer, pancreatic cancer

and multiple myeloma, tended to have more pre-referral consultations.

The findings, published in the British Journal of Cancer, show that progress has been made in efforts to improve the timeliness of GP diagnosis and referral of early cancer symptoms such as through the use of clinical decision support tools and fast-track referrals, says study author Dr Georgios Lyratzopoulos, from the Cambridge Centre for Health Services Research.

The researchers say that encouraging GPs to refer patients with non-specific symptoms may improve the timeliness of diagnosis but at the cost of more false positives, patient anxiety and overinvestigation.

They concluded: ‘Improving the sensitivity of symptom appraisal by GPs to detect cancer symptoms should be prioritised by research and policy initiatives. Development and evaluation of interventions can particularly focus on patients with difficult-to-suspect cancers.’


          

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