GPs urged to refer thousands more patients in updated NICE cancer guidance

GPs are being urged to refer patients with less-obvious cancer symptoms as NICE lowers risk thresholds and qualifies thousands more patients for specialist cancer care in updated guidance.

GPs are advised to send thousands more patients with less-obvious symptoms of cancer through referral pathways. Pic: Jason Heath Lancy
GPs are advised to send thousands more patients with less-obvious symptoms of cancer through referral pathways. Pic: Jason Heath Lancy

GPs should be on the look out for ‘general’ cancer symptoms that can be ‘similar to those of other conditions’ – and must refer patients to specialists or direct diagnostics earlier, according to the NICE’s latest cancer guidance for primary care.

In the older 2005 guidance, patients with a positive predictive value (PPV) of cancer of 5% or higher were recommended for referral to cancer scans, but this threshold has now been lowered to 3% in a bid to drive more referrals and diagnose cancers earlier.

In real terms, this means GPs are now advised to send thousands more patients with less-obvious – and potentially earlier – symptoms of cancer through referral pathways.

For children and young people, GPs are particularly advised to refer for suspected cancer earlier and for subtler symptoms.

GPs need direct access

RCGP chairwoman Dr Maureen Baker welcomed the guidance, but warned: ‘What is really needed is giving GPs easier access to diagnostics, such as CT and MRI scans and ultrasound, that could make a real difference to our patients.’

She added: 'Timely diagnosis of cancer is a priority for the RCGP, so we welcome any support that will help GPs identify signs of cancer as early as possible.'

The draft guidance is arranged in a table so GPs can easily see which symptoms have been linked to which cancers. Each symptom has a list of recommended actions for referrals and tests.

NICE said the new guidance should ‘better support GPs and other primary healthcare professionals’.

Delays in spotting the early signs and symptoms of cancer ‘could be costing the lives of thousands of people’ every year, it added.

Professor Mark Baker, NICE’s clinical practice director, said: ‘It is not always easy for GPs to spot cancer. We are updating our guideline to make things as simple as possible for GPs to consider the possibility of cancer and refer people to the right service at the right time. Early referral and diagnosis can help save lives.’

Sara Hiom, Cancer Research UK’s director of early diagnosis, welcomed the guidance, but also called for ‘better access to diagnostic tests’ for GPs.

Nearly one in every two people will develop cancer during their lifetime.

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