GPs need rapid access to cancer tests to speed up diagnosis, says RCGP

GPs need better access to cancer tests, the RCGP has warned, after research showed that one in four patients experience avoidable delays to diagnosis.

Professor Martin Marshall (Photo: Pete Hill)
Professor Martin Marshall (Photo: Pete Hill)

A Cancer Research UK study found that almost 3,400 patients experienced an avoidable delay in their cancer diagnosis over a one-year period.

The study found that 13% of avoidable delays happened before the patient saw their GP, 49% while the patient was being assessed by the GP surgery - including waiting for tests to be done and results to be sent back - and 38% after referral to hospital.

Around half of patients who experienced an avoidable delay waited around two months longer to be diagnosed compared with patients who did not experience a delay.

Waiting times

Long waiting times for tests were responsible for a quarter of all avoidable delays across GP surgeries and hospitals, which report authors said indicated staffing shortages among diagnostic staff in hospitals. Vague symptoms that GPs may not immediately attribute to cancer were also a factor.

RCGP chair Professor Martin Marshall said GPs were doing a ‘good job’ referring patients in a ‘timely way’, but that 'appropriate training' could improve referral decisions. He said a shortage of staff in the NHS was also contributing to unecessary delays in cancer diagnosis.

The findings come as government figures revealed in July that patients had to wait more than two weeks for a GP appointment in around 17% of cases, reflecting the pressures on GPs to deal with patient demand.

Professor Marshall said: ‘GPs have to balance the risk of not referring a patient with that of over-referring, which can cause unnecessary concern for patients and risks overloading specialist services. It’s a decision that is exacerbated as many symptoms of cancer are vague and often likely to be other, more common conditions.

Diagnostic tests

‘The college has been calling for many years for GPs to have better access to diagnostic tests in the community – and the appropriate training to use them - so that our decisions to refer can be better informed, and in turn ease pressures elsewhere in the health service.

‘Steps should undoubtedly be taken to reduce avoidable delays in cancer diagnosis – and lessons should be learnt from this study, which very clearly shows that the main problem is not having enough people, right across the system, to do what needs to be done to ensure patients receive the care they need when they need it.'

Cancer Research UK’s GP expert Dr Richard Roope agreed that GPs needed more help to improve improve patient cancer care. He said: ‘GPs are working hard across the UK to make sure that patients are diagnosed quickly by referring more people earlier for tests. But we see patients with a huge variety of symptoms, often non-specific ones, and it can be difficult to decide when to check for cancer.

‘As healthcare professionals, we all play a role in ensuring people are diagnosed quickly and research that shows us where we can do better is very valuable. Remember that your GP wants to see you if you have any concerning symptoms, so if you have persistent symptoms or you notice anything that’s different for you, such as weight loss, bleeding, pain or a new lump, book an appointment to see your GP as soon as you can.’

A major independent review of cancer screening in England recommened in October that GP practices and primary care networks could be incentivised for increasing uptake of cancer screening

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