According to a new report from the Royal College of General Practitioners (RCGP), in England three quarters of individuals with cancer symptoms are evaluated, examined and referred within one month of presenting their symptoms to their GP. The report, the first of its kind, is published by the RCGP’s Clinical Innovation and Research Center (CIRC).

The report details findings of the 2009/2010 National Audit of Cancer Diagnosis in Primary Care which was conducted as part of the National Awareness and Early Diagnosis Initiative.

The study is the largest and most comprehensive investigation regarding primary care to cancer diagnosis to date, covering 1 in 7 practices throughout England.

Intervals in the diagnostic pathway were analyzed in the audit, which looked at the primary care interval – defined as the time period between individuals first presenting their symptoms to their GP to date of referral, as well as the referral interval – the time period between a patient being referred and the date the individual first attended secondary care.

According to the report:

  • After only one or two consultations, 73.2% (three quarters) of individuals were referred to a specialist by their GP.
  • Within two weeks almost 60% of all patients referred (57.1%) attended secondary care.

After examining the use of investigations, the report discovered that some cancer patients, including those with cancer of the liver, kidney, brain, ovary and pancreas, were more likely to have benefited from improved Primary Care access to diagnostics including ultrasounds, brain MRIs, non-obstetric, GI endoscopies as well as X-rays. Overall, in 6% of cases, fast access to investigations would have changed the GP’s management of the patient.

Professor Greg Rubin, Professor of General Practice and Primary Care at Durham University and RCGP Project Lead for the Audit, explained:

“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 with this.”

Dr. Clare Gerada, RCGP Chair, stated:

“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), explained:

“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 analyze data from the time a patient first visits their 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.”

Written by Grace Rattue