About the research
Around one in three people will develop cancer in their lifetime, with nearly 300,000 new cases reported in the UK each year. Diagnosing cancer before it has spread makes treatments more effective and can help achieve cure. For most patients, the process of cancer diagnosis starts with a visit to see their General Practitioner (GP) when any signs or symptoms appear. When the GP suspects cancer, typically the patient is referred to hospital for further investigations.
Researchers from the University of Cambridge, Bangor University and the University of Durham wanted to understand variation in the number of times a patient with cancer symptoms had to visit their GP before hospital referral. Better understanding such variation can help target future research and interventions on those patients at higher risk of a non-prompt diagnosis. They used data from the 2010 Cancer Patient Experience Survey.
Three quarters of cancer patients were referred to hospital after one or two consultations. However, the proportion of cancer patients who saw their GP three or more times before a hospital referral varied greatly between patients with different cancers and characteristics. For example, while only 7 per cent of breast cancer patients had three or more pre-referral GP consultations, pancreatic cancer patients had three or more consultations 41 per cent of the time. The researchers believe these findings reflect the difficulties of suspecting cancer when there are no specific symptoms. Cancer patients who were young or women or belonged to an ethnic minority were all more likely to have three or more pre-referral consultations. These findings can reflect greater diagnostic challenges in these groups, for example because cancer is rarer in young people, or because of communication difficulties with older ethnic minority patients.
These findings are of relevance to the National Awareness and Early Diagnosis Initiative that aims to improve cancer outcomes by detecting cancer earlier. It is hoped this research can guide future research and initiatives by focusing on patient groups at higher risk of experiencing a non-prompt diagnosis.
Methodology
The researchers used data from 41,299 patients with 24 different types of cancer whose diagnosis involved first visiting their GP with cancer symptoms.
The researchers used multivariable logistic regression to identify independent predictors of three or more pre-referral consultations with a GP before hospital referral.
Publications
Lyratzopoulos, G., Neal, R.D., Barbiere, J.M., Rubin, G.P. and Abel, G.A. (2012) ‘Variation in number of general practitioner consultations before hospital referral for cancer: Findings from the 2010 National Cancer Patient Experience Survey in England’, The Lancet Oncology, 13(4), pp. 353-365. doi:10.1016/S1470-2045(12)70041-4 Retrieved 6 September 2013 from http://dro.dur.ac.uk/9316/1/9316.pdf
Adams, S. (24 February 2012) ‘GPs “slow to refer ¼ of cancer patients”‘, The Telegraph [Web version]. Retrieved 6 September 2013 from http://www.telegraph.co.uk/health/healthnews/9101153/GPs-slow-to-refer-14-of-cancer-patients.html
Gallagher, J. (24 February 2012) ‘Longer cancer referral times for young, women and ethnic minorities’, BBC News. Retrieved 6 September 2013 from http://www.bbc.co.uk/news/health-17138692
Hope, J. (24 February 2012) ‘”Cinderella cancers” that doctors miss: Multiple visits to the GP needed for proper diagnosis’, The Daily Mail [Web version]. Retrieved 6 September 2013 from http://www.dailymail.co.uk/health/article-2105607/Cinderella-cancers-doctors-miss-Multiple-visits-GP-needed-proper-diagnosis.html
Praities, N. (24 February 2012) ‘Study reveals GP diagnosis delays for different cancers’, Pulse. Retrieved 6 September 2013 from http://www.pulsetoday.co.uk/study-reveals-gp-diagnosis-delays-for-different-cancers/13507219.article#.UinZEn_3On4