Concerns grow over GPs' failure to refer young cancer patients

Posted: 22/05/2012

The Teenage Cancer Trust has just completed a survey of cancer patients aged between 13 and 24. Alarmingly, the survey indicated that a quarter of young people with cancer visited GPs four times or more before their symptoms were taken seriously and they were referred to a specialist, resulting in investigations and diagnosis. This is the first time that this age group has been highlighted as having a serious issue with delayed cancer diagnosis. In most cases patients were reassured by their GPs that they had something non specific, such as an infection or virus.

Penningtons' clinical negligence team sees many cases where GPs make a diagnosis of the most common and least serious explanation for symptoms, without examing less frequent but potentially more severe causes, and/or fail to take stock when patients reattend and consider that the ongoing symptoms no longer fit with the original diagnosis. It is worrying that this is happening increasingly often with young patients, despite the fact that there are good pathways in place for quick investigation once cancer is suspected. It goes without saying that, dependent on the nature of the cancer, delays in referral to a specialist can result in delayed diagnosis and treatment and may mean that the cancer is more advanced by the time it is diagnosed. The patient may then need more radical surgery, chemotherapy or radiotherapy, which may not have been required with an earlier diagnosis. Patients may also have a poorer prognosis and higher risk of spread / recurrence as a consequence.

In the light of these findings, the trust launched the first teenage cancer awareness week this month and has produced a pack for schools about signs and symptoms that children and young adults should be alert to. Five of the most common warning signs in young people are unexplained and persistent pain; a lump, bump or swelling; extreme tiredness; significant weight loss; and changes in a mole. The emphasis is on educating young people to note these symptoms and to return to their GP if they persist.

Philippa Luscombe, partner in the clinical negligence team at Penningtons, said: "Sadly, over the last few years we have seen increasing numbers of claims against GPs for a failure to refer resulting in a delay in diagnosis of cancer. At best this delay causes huge anxiety when a diagnosis is made but in many cases the delay can have a very significant impact on treatment and outcome for such patients. Despite there being guidelines in place about factors to prompt referral, people are still slipping through the net. The growing amount of young people in this category is of real concern. We wholeheartedly support the Teenage Cancer Trust's focus on this issue and the provision of education to young people in an informative but non alarmist way so that they can raise these issues with GPs and discuss reasons for referral - or indeed, non referral."

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