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Wide variation in GP referrals for suspected cancer

GP referrals for suspected cancer through the two-week pathway are under scrutiny, after Government figures released today showed they varied threefold between practices.

The data, prepared by the National Cancer Intelligence Network (NCIN), shows the variation in urgent referrals by GP practices to hospital specialists ranges from under 830 to over 2,550 in every 100,000 people per year.

Patient groups have said the variation is ‘very worrying', but GP experts say the absolute numbers are not as important as diagnosis rates.

The figures show that the average GP will see seven patients who have cancer each year. These break down as one case each of breast, bowel, prostate and lung cancers, plus three cancers of other types.

Di Riley, associate director for the NCIN clinical outcomes programme, said it was looking into the causes of variation.

She said: ‘It is important to remember that GPs have a hard job and many of the symptoms of cancer are very similar to many other illnesses. But we must do more to understand the reasons for the variation.'

Sarah Woolnough, executive director of policy and information at Cancer Research UK, said the results were ‘very worrying'.

She added: ‘Although the number of people GPs suspect have cancer and send for further tests will naturally vary depending on the age and demographic of the patients, this level of variation suggests differing approaches by some GPs.'

But Professor Greg Rubin, RCGP and Cancer Research UK clinical lead for cancer, said that what is important is to improve the number of cancers detected through the two-week referral system.

He said: ‘There is good evidence that there is a terrific variation in the way GPs use the two-week pathway. What we see is that some practices use it a lot, but relatively few of these patients have cancer. Other practices use it very little, but most of the patients referred have cancer.

‘What matters is not really how many patients you refer, but how many of those patients are diagnosed with cancer. We would like to see a high detection rate through the two-week wait pathway.'

Click here to view the data in full

For more, watch The Big Interview on on Thursday 2 August with RCGP and Cancer Research UK clinical cancer lead Professor Greg Rubin.


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