This site is intended for health professionals only

Cancer diagnosis delays during GP assessment are due to lack of tests, says research

Cancer patients who experience a delay in diagnosis are being held up at the GP assessment stage due to tests taking too long and being unable to detect vague symptoms, a new study has found.

Around one in four cancer patients do not receive their cancer diagnosis as quickly as they should due to avoidable problems, according to the study, funded by Cancer Research UK.

The study, published in Cancer Epidemiology, involved GPs assessing more than 14,000 patient records in England from 2014.

Researchers found the reasons for delayed diagnosis existed along the entire pathway – from before the patient presented, to being seen by a GP, through to specialist care.

An avoidable delay occurred in 24% of cases, with 49% of those occurring during GP assessment – including waiting for test results – 38% after referral to hospital and 13% before the patient saw their GP.

Having a greater number of comorbidities, cancer at certain sites (pancreatic, colon, rectal, and stomach cancer), and being referred through routes other than the two-week wait were more likely to be associated with a delay.

In deprived areas, delays were more commonly associated with the patient taking longer to seek help.

The study authors said delays could be ‘significantly’ reduced by speeding up tests and developing new versions.

Study leader Ruth Swann, senior cancer information analyst at Cancer Research UK, said: ‘Our research shows there’s a good opportunity to significantly reduce delays by cutting the time it takes for patients to have tests done.

‘We need more research to develop and evaluate new diagnostic tests for patients with vague symptoms and a better way to manage them.’

Commenting on the fundings, the RCGP highlighted that GPs were working hard to refer quickly, but agreed the study showed GPs need to have faster access to diagnostic tests.

RCGP chair Professor Martin Marshall said: ‘GPs are doing a good job of referring patients we suspect of having cancer in a timely way. Research shows that nearly 80% of all cancer cases are now referred after only one or two consultations – and this is happening despite the widely acknowledged workload crisis in general practice.’

He said that GPs have to balance the risk of not referring a patient with that of over-referring, which can cause unnecessary concern for patients and risks overloading specialist services.

‘It’s a decision that is exacerbated as many symptoms of cancer are vague and often likely to be other, more common conditions,’ he said.

He added: ‘Steps should undoubtedly be taken to reduce avoidable delays in cancer diagnosis – and lessons should be learnt from this study, which very clearly shows that the main problem is not having enough people, right across the system, to do what needs to be done to ensure patients receive the care they need when they need it.


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.