GPs quick to refer suspected cancer

GPs refer more than 80 per cent of suspected cancer cases within two consultations, new research has revealed.

More than half (58 per cent) of patients were referred after the first consultation while a quarter were referred after two. In only five per cent of cases it took five or more consultations to initiate a referral.

The findings were published in a report in the British Journal of Cancer which used data from the English National Audit of Cancer Diagnosis in Primary Care 2009-2010. The report looked at the link between the length of time from first symptomatic presentation to specialist referral, and the number of pre-referral consultations. The data covered 13,035 people with any of 18 different cancers.

Patients with certain types of cancer were more likely to have a greater number of pre-referral consultations. Those diagnosed with multiple myeloma and lung cancer had high proportions of three or more pre-referral consultations (46 per cent and 33 per cent respectively). Breast cancer and melanoma patients were generally referred sooner, with only three per cent and five per cent of each patient group requiring three or more pre-referral consultations.

The number of pre-referral consultations was found to be closely associated with the time from first presentation to specialist referral but no connection was found between referral time and a patient’s age, sex or ethnicity.

The researchers concluded: “Developing interventions to reduce the number of pre-referral consultations can help improve the timeliness of cancer diagnosis, and constitutes a priority for early diagnosis initiatives and research.”

They said the results underline the need to speed up cancer diagnosis through means such as GP clinical decision support tools, as well as raising awareness of the importance of persistent symptoms.

They said: “Improving the sensitivity of symptom appraisal by general practitioners to detect cancer symptoms should be prioritised by research and policy initiatives. Development and evaluation of interventions can particularly focus on patients with difficult-to-suspect cancers.”