This site is intended for health professionals only


Cancer diagnoses occurring outside referral guidelines

Many patients referred urgently by GPs as suspected cancer cases outside the terms of referral guidelines go on to have a cancer diagnosis, new research reveals.

The authors warned the results suggested cancer cases could be missed if GPs were expected to stick too rigidly to national guidelines. A review of nearly 19,000 urgent referrals by GPs in 516 Scottish practices found wide variation in rates of cancer referral and subsequent detection – much unexplained.

The study, published in November's British Journal of General Practice, found after excluding practices with the highest and lowest 10% of referral rates, variation remained at six-fold. There was no association between the proportion of urgent referrals and published cancer rates for the most common cancers.

Self-reported compliance with cancer referral guidelines was 9.9% and 18.1% of those cases were diagnosed with cancer. However, 7.7% of referrals – 56 out of 734 – considered outside the guidelines also had an eventual diagnosis of cancer.

Study leader Dr Paul Baughan, a GP in Dollar, Clackmannanshire, and chair of the Scottish Primary Care Cancer Group, said: ‘GPs should be able to refer urgently even if it doesn't quite fit guidelines. The 7.7% indicates that guidelines are useful, GPs have the skills to pick up subtle signs they don't cover.'


          

Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.