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At the heart of general practice since 1960

NICE triggers row over rationing of statins...

GPs welcome long-awaited guidance on cancer referrals as a giant stride forward, writes Emma Wilkinson

GPs have heralded NICE guidance on referral for suspected cancer as the most significant advance in primary care oncology in years.

NICE claims the new document, which covers 12 cancer categories, will finally eradicate variations in the time it takes to refer patients from primary to secondary care.

The guidelines include significant revisions to the sections on lung, ovarian and gastrointestinal cancer and the first detailed guidelines on diagnosis of childhood cancer.

RCGP chair Dr Mayur Lakhani said the guidelines were in 'a different league' from those previously available and would be vital in avoiding litigation from delayed diagnosis. 'I don't think GPs can ignore these guidelines,' he said.

'We did some work around medicolegal litigation and found the most common reason was for missed or delayed diagnosis of cancer. There were more than 100 cases last year. The stakes are very high.'

Dr Ivan Cox, chair of the guideline development group and a GP in Birmingham, said: 'We are being a lot more sophisticated about saying what GPs should do and when to refer urgently.'

Dr David Wild, a GP in Hebden Bridge and cancer lead for Calderdale PCT, said GPs were in urgent need of the new guidance.

www.nice.org.uk

Guidance at a glance

·Lung ­ chest X-ray after three weeks of symptoms

·Upper GI ­ urgent endoscopy with recent-onset dyspepsia

·Lower GI ­ watch and wait with equivocal symptoms

·Gynaecological ­ ultrasound recommended

·Urological ­ urgent referral in over-40s with recurrent UTI

·Skin ­ no GP to excise melanoma

·Head and neck and thyroid ­ first ever guidance

·Children ­ first detailed recommendations

·Brain, breast, bone, haematological ­ no change

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