Cancer charities have issued a cautious welcome to a new report showing that three-quarters of patients with symptoms of cancer in England are assessed, investigated and referred within a month of presenting to their GP.
The first-of-its-kind study, published by the Royal College of General Practitioners (RCGP)’s Clinical Innovation and Research Centre (CIRC), describes the findings of the National Audit of Cancer Diagnosis in Primary Care, which was undertaken in 2009-10 as part of the National Awareness and Early Diagnosis Initiative.
Among its fundings are that 73.2% of patients visiting their GP were referred to a specialist after only one or two consultations, and that 57.1% of patients referred attended secondary care within two weeks.
The report also looked at the use of investigations, and found that some cancer patients, including those with brain, ovary, pancreas, liver and kidney cancer, were more likely to have benefited from better primary care access to diagnostics including chest x-rays, non-obstetric ultrasounds, gastrointestinal endoscopies and brain magnetic resonance imaging (MRI) scans.
Overall, rapid access to investigations would have altered GPs’ management of the patient in 6% of cases, it says.
The report provides the first detailed analysis of how GPs diagnose cancer, and while the good news is that many patients are identified promptly as needing specialist assessment, “we could do better, and improved access to cancer tests would help in this,” said Greg Rubin, professor of general practice and primary care at Durham University and RCGP project lead for the audit.
RCGP chair Dr Clare Gerada added that the report shows that GPs do a very good job of identifying their patients who have cancer and in referring them quickly for specialist treatment.
“While there are groups of patients where we do, for various reasons, have difficulty in making a rapid diagnosis, we must be proud that the majority are being identified and put into secondary care quickly. At the same time, we must always be looking at how we can improve,” she said.
Macmillan Cancer Support described the findings as “encouraging,” but said there are still far too many people who are visiting their GP five times or more before being sent for diagnostic tests.
“This is not good enough – early diagnosis can make a real different to cancer survival,” said Mike Hobday, director of policy and research at the charity.
“We are working with our Macmillan GPs and others to trial some easy-to-use symptom toolkits to help make better progress in earlier diagnosis,” he added.
Cancer Research UK’s director of information, Sara Hiom, also described the report’s main finding as “good news,” but added: “it’s important that GPs don’t rest on their laurels as too many patients still slip through the net.”
“As this audit shows, one in four is not seen promptly so diagnosis and treatment may be delayed,” said Ms Hiom.
Chris Carrigan, head of the National Cancer Intelligence Network (NCIN) pointed out that while collecting and evaluating the data presented in the report is crucial to provide the knowledge to improve early detection, they only “give us one piece of a jigsaw puzzle.”
“We need to continue to hunt for these pieces of data so that we can build a clear picture of where delays could be occurring,” he said, adding: “early detection really is the key to improving survival rates in the country in order to bring England’s cancer survival in line with the best in Europe.”
