GPs and cancer diagnoses

Medscape Medical News > Oncology
UK Reform Empowers PCPs to Improve Cancer Diagnoses

Liam Davenport June 25, 2015


A new cancer strategy for primary care practitioners that places an emphasis on early recognition and referral could save thousands of lives in the United Kingdom every year, says the UK's health watchdog.

The National Institute for Health and Care Excellence (NICE) issued new guidelines this week that focus on symptom-led cancer diagnosis in primary care, expand the tests available to general practitioners, and set out maximum referral times.

For example, the new guidelines mean that general practitioners (the British term for primary care physician) will now be able to order fasttrack endoscopies and MRI and CT scans, which were previously available only after specialist referral to a hospital.

Professor Mark Baker, clinical practice director at NICE, said in press release: "The best way to successfully treat cancer is to make an early diagnosis. The sooner the disease is identified, the more likely treatment is to be effective."

Britain has lagged behind "the best European countries" in terms of cancer outcome statistics, he said in a television interview. "The main reason for that is that people tend to present with a cancer at a more advanced stage."

People tend to present with a cancer at a more advanced stage. Prof Mark Baker


The new guidelines will save an estimated 5000 lives a year, according to Prof Baker.

The charity Cancer Research UK estimates that there more than 160,000 deaths due to cancer per year in the United Kingdom. Recent research suggests that up to 10,000 cancer deaths could be prevented each year in England alone with earlier diagnosis and more appropriate surgery.

Moreover, cancer survival rates in the United Kingdom and Ireland are low compared with the rest of Europe for a number of types of malignancies, including kidney, stomach, ovarian, colon, and lung cancers.

To bridge the gap, new recommendations shift the emphasis away from considering whether a patient has cancer and then crosschecking it against the symptoms and toward focusing on a patient's symptoms and then linking them to possible cancers and selecting the most appropriate tests.

NICE provided examples of their new proactive recommendations. For example, fatigue that is unexplained in an individual older than 40 years who has ever smoked would point to a chest X-ray for lung cancer and, in a woman, would merit a blood test for ovarian cancer.