Three quarters of patients with cancer are referred within one month
(25 November 2011)
Three quarters of patients with symptoms of cancer in England are assessed, investigated and referred within a month of presenting to their GP, according to research led by Durham University.
To date, it is the largest and most comprehensive study of the primary care pathway to cancer diagnosis, covering one in seven practices in England.
The audit, published by the Royal College of GPs (RCGP), examined intervals in the diagnostic pathway, looking at the primary care interval - defined as the time between first presentation and date of referral, and the referral interval - the period between referral and the date the patient first attended secondary care.
The report - the first of its kind - found that:
- Three quarters (73.2%) of patients visiting their GP were referred to a specialist after only one or two consultations.
- Nearly 60% of all patients referred (57.1%) attended secondary care within two weeks.
The report also looked at 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, GI endoscopies and brain MRIs. Overall, rapid access to investigations would have altered the GP's management of the patient in 6% of cases.
Professor Greg Rubin, Professor of General Practice and Primary Care at Durham University and RCGP Project Lead for the Audit said: "This report provides the first detailed analysis of how GPs diagnose cancer. The good news is that many patients are identified promptly as needing specialist assessment, but we could do better and improved access to cancer tests would help in this."
RCGP Chair Dr Clare Gerada said: "This report shows that in General Practice we do a very good job of identifying our 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.
"The report confirms that the foundations that will enable us to continue to provide a quality service are already in place, and that they are the attributes of quality General Practice - continuity of care; patient centeredness and shared decision making; clinical acumen and sound diagnostic skills."
Chris Carrigan, Head of the National Cancer Intelligence Network (NCIN), said: "Collecting and evaluating data on how quickly cancer patients are sent for referral by their GP is crucial to equip us with the knowledge to improve early detection of the disease. This study allowed us to analyse data from the time a patient first visits the GP with symptoms to follow up tests at the hospital. But understanding and improving diagnosis, treatment and outcomes for patients is complex.
"These data give us one piece of a jigsaw puzzle but 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. 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."
The report was published by the RCGP's Clinical Innovation and Research Centre (CIRC) and describes the findings of the National Audit of Cancer Diagnosis in Primary Care, undertaken in 2009/2010 as part of the National Awareness and Early Diagnosis Initiative.