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Independents' Day

Lack of GP time and workforce shortages a factor in late cancer diagnosis

Over 100,000 cancer patients are diagnosed too late for optimum chances of survival each year, calculations from Cancer Research UK have found.

Lack of Government action in overcoming the NHS’ understaffed workforce as well as GPs not having enough time to properly investigate are 'large contributors' to this figure, according to the charity. 

Almost half of all cancers diagnosed in England are at stage 3 or 4 at time of diagnosis. Of these, approximately 67,000 people are diagnosed at stage 4, the most advanced, restricting the availability of treatment options. 

Last year, the Government pledged to improve the number of people diagnosed with early-stage cancer – aiming to jump from two in four being diagnosed early, to three in four by 2028. In light of this, Cancer Research UK has concluded that this is only achievable if an extra 100,000 patients are diagnosed early each year by 2028.

Nine out of 10 bowel cancer patients will survive if the disease is caught at its earliest stage, but this declines to just one in 10 surviving for at least five years if they aren’t diagnosed until the latest stage. 

Cancer Research UK’s director of early diagnosis, Sara Hiom, told Pulse: ‘GPs are most people’s first port of call when they notice symptoms, so they are vital to diagnosing early stage cancer. GPs have been referring more patients with suspected cancer for investigation, which is important for early diagnosis.

‘But as their workloads grow and the number of GPs declines, they have less and less time with patients. This makes it more difficult for GPs and patients to have the right conversations and therefore onward referral can be delayed.'

She added: ‘It’s concerning that so little progress has been made in recruiting more GPs. Recruiting more staff such as clinical pharmacists and physician associates should help, but the NHS needs more GPs if the Government’s ambitions on early diagnosis are going to be met.’

Cancer Research UK also estimates that by 2027, the NHS needs:

  • An additional 1,700 radiologists – increasing the total to nearly 4,800,
  • To almost triple its amount of oncologists – increasing the total from 1,155 to 3,000,
  • Almost 2,000 additional therapeutic radiographers – increasing the total to almost 4,800.

The charity said: 'There are lots of things that can influence how early or late someone is diagnosed, but workforce shortages are a large contributor.

'There just aren’t enough of the right staff available on the ground now, and there are no plans to significantly increase the numbers needed to transform the health service.'

It was recently announced that fewer cancers are being diagnosed as emergencies. However, cancer has also been named the biggest cause of difference in life expectancy in certain deprived areas. 

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Readers' comments (8)

  • Suxk it up UK the five year plan of most grass roots GPs is how get out.

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  • Interesting where these recruits will come from.

    Even more interesting will be National Cancer Diagnosis Audit that is comparing date pre and post NG 12 release.

    Less via emergency presentation now, change in PPV of symptoms from 5% to 3% results in more referrals with a lower conversion rate.

    My money is NCDA data will show shift in bulk of delays in system to Secondary Care.

    This returns us again to where are the relevant minions and capacity going to be magically found.

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  • Vinci Ho

    Once again , my mother is w woman . Thanks ( but no thanks) for telling me that .

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  • The usual government response is to have more guidelines, increase standards etc. all in the good name of safety, without providing the staffing or resources. No wonder people are leaving. The system is actually more dangerous now.

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  • Truth finder, you are right. What is even more worrying is that the royal colleges have jointly issued a directive saying that the standard of care for negligence should be determined by these guidelines. From a pragmatic stance it would make more sense to cut the number of people who go for the diagnostic tests to what is actually achievable.

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  • Cancer's just another money making machine now. All these guidelines support ever increasing medicalisation for less and less return on the investment. Meanwhile any GP who 'misses' cancer is ripe for investigation and legal redress. No-one is prepared to admit that often diagnosing cancer is hard, patients present with myriad symptoms and it can be very difficult to identify which ones matter. This is always judged in hindsight by people who work in ivory towers and are paid handsomely to promote ever more complex guidelines whilst further cuts are made to resources.

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  • Is it possible to prove that 'guidelines' improve patient survival?

    Has the question been asked or answered?

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  • Don't think a pathway for abnormal CXR has helped much, last 2 had hematology malignancy so later diagnosis and as smokers went down respiratory route first.

    NICE has 3% PPV with around 8% national conversion rate of 2WW referrals. Average 12 cancers a year per GP so means I ought to make around 150 referrals as 2WW per annum.

    Good news for secondary care capacity is I don't refer that much and they certainly don't go straight to Hospice when I do refer.

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