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Patients put off going to GP with cancer ‘alarm’ symptoms

Many patients are delaying going to their GP about potential cancer symptoms because they put them down to less serious illnesses, a study of people registered at three London GP practices has revealed.

The study, published in open access journal PLoS ONE, showed more than half (53%) of the 1,700 people surveyed had experienced at least one cancer ‘alarm’ symptom in the past three months – yet only 2% said they thought cancer was a possible cause.

Instead, they tended to put the symptoms down to age or illnesses like infections, arthritis, piles and cysts.

This contradicts criticism of GPs over wide variations in cancer referrals, with threats to ‘name and shame’ individual GPs for low referrals for cancer investigations, suggesing that patients aren’t actually visiting practices.

Unexplained lumps were the most likely to alert the patient to potential cancer, but still only 7% of patients reporting this symptom recognised cancer as a possible cause. Changes in bladder habit, persistent unexplained pain and unexplained weight loss were never acknowledged to be cancer symptoms. 

Lead researcher Dr Katriina Whitaker, senior research fellow at University College London, said: ‘It’s worrying that even the more obvious warning symptoms, such as unexplained lumps or changes to the appearance of a mole, were rarely attributed to cancer, although they are often well recognised in surveys that assess the public’s knowledge of the disease.

‘Even when people thought warning symptoms might be serious, cancer didn’t tend to spring to mind. This might be because people were frightened and reluctant to mention cancer, thought cancer wouldn’t happen to them, or believed other causes were more likely.’

Sara Hiom, director of early diagnosis at Cancer Research UK, said: ‘Most cancers are picked up through people going to their GP about symptoms, and this study indicates that opportunities for early diagnosis are being missed. Its results could help us find new ways of encouraging people with worrying symptoms to consider cancer as a possible cause and to get them checked out straightaway with a GP.’

NICE last week launched a consultation on new proposed guidelines for investigating suspected cancer, aimed at getting more patients referred or tested earlier for cancer by their GP.

The study comes as another piece of research – published in the Lancet today – showed that while overall cancer survival has improved in the UK over the past 40 years, with a doubling in the proportion of patients surviving for more than 10 years, there has been little or no improvement in survival for certain cancers including the brain, stomach, lung, oesophagus, and pancreas since the 1970s.

PLoS ONE; available online 3 December