Study suggests UK GPs are slower to refer patients who may have cancer

Posted: 29/05/2015

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GPs in the UK are slower to refer patients who show symptoms of cancer than in other countries, according to a new study. 

Researchers gave doctors in England, Wales, Northern Ireland, Norway, Sweden, Australia and Canada a series of hypothetical scenarios during a phone interview. This included a 53-year-old woman who had her last period six months ago and had suffered abdominal pain for the last three weeks. These are potential symptoms for ovarian cancer but could also point to many other diseases. 

In the UK 38% of doctors stated that they would refer the patient for cancer testing while the figure was 61% in the other countries. Cancer Research UK said the percentage of ovarian cancer patients surviving one year or more after diagnosis was 65% in the UK and 73% in the rest of the world. 

There was a consistent theme through all scenarios.

Sara Hiom, the director of early diagnosis at Cancer Research UK, commented: "This work adds important detail to the complex problem of why the UK's cancer survival lags behind other comparable countries. GPs have a difficult job to do. They have to ensure those who need specialist tests get them, without overloading a health system that's already strained. But their role as gatekeepers to further investigation and specialist care does need to be reviewed in the current context. If the UK system means that patients are not being referred for tests, or GPs aren't able to get a specialist opinion as necessary, then this can contribute to cancers being diagnosed and treated at a later stage and we urgently need to address this."

The findings come after NHS England announced plans to speed up early diagnosis in the UK through a range of initiatives including lowering thresholds for cancer referral. These are to be backed up by planned new NICE guidelines on suspected cancer and increasing GP direct access to cancer diagnostic tools.

Dr Richard Roope, a representative of the Royal College of GPs, said most doctors in the UK did not have direct access to CT and MRI scans, which meant they were likely to try other tests first. Another issue he identified was that doctors tested for one condition at a time, while other countries tested for all possibilities at once. He called for more investment in general practice to allow increased employment of GPs and support staff and to give GPs more access to technology that could ultimately save patients’ lives.

Rebecca Morgan of Penningtons Manches’ clinical negligence team added: “We act for a number of clients whose cancer diagnosis has been delayed despite having symptoms for some time. The key to survival is early diagnosis. It is therefore important to support significant, ongoing public awareness campaigns to educate the public about the causes of cancer and encourage people who have signs of cancer to approach their GP as early as possible.”

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