GP leaders said the data showed that the profession was 'doing a good job' at identifying patients with cancer, but warned that UK GPs have 'some of the worst access to diagnostic tools' in Europe.
The results draw on data from 439 GP practices covering 17,000 cancer patient diagnoses that took place in 2014, and have been hailed as the ‘most detailed analysis to date’ by charity Cancer Research UK.
Researchers say the data will provide a baseline for future audits of the impact of NICE’s 2015 cancer management guidance – as well as identifying potential avenues for quality improvement.
Almost three quarters (72%) of cancer patients first report symptoms at the GP surgery, according to the research published in the British Journal of General Practice (BJGP). Half were diagnosed within 40 days.
Cancer referral
One in five patients experienced an avoidable delay somewhere along the diagnostic pathway. A third of these were due to factors linked to the healthcare system, such as having to wait for a test or an appointment.
Researchers said specialist diagnostic scans that led to cancer diagnosis were not ordered often enough by GPs. GPonline reported earlier this year that many GPs were denied the ability to refer patients directly for cancer scans, and that many had referrals on the two-week cancer pathway bounced back or downgraded.
The researchers said: ‘For policymakers, this audit provides a baseline against which the impact of subsequent initiatives to improve cancer diagnosis, such as the 2015 NICE guidance on recognition and referral of suspected cancer and the implementation of the Achieving World Class Cancer Outcomes Cancer Strategy 2015–2020 can be assessed.
‘It provides pointers to where implementation efforts might best be directed, for example, in achieving the 28-day standard from referral to diagnosis.
‘It appears that, despite efforts since 2012 to increase access to specialist investigations such as imaging or endoscopy, these are not widely ordered by GPs for patients subsequently diagnosed with cancer, who are however investigated after a specialist referral.’
RCGP chair Professor Helen Stokes-Lampard said: 'This large and comprehensive national audit shows that GPs are doing a good job at identifying patients they suspect of having cancer, and referring them in an appropriate and timely manner – within five days of initial presentation.
'While almost half of patients are being diagnosed within 28 days from referral, where diagnosis took longer, it must be recognised that in the vast majority of cases GPs did not consider the delays to be avoidable.
'Where avoidable delays were reported, the reasons for this were wide-ranging, so while they must be addressed, any finger-pointing is not helpful.
'It certainly remains the case that GPs in the UK have some of the worst access to diagnostic tools in the community in Europe. We need better access to both existing and emerging tests and imaging tools that could help us identify cancers, particularly those with symptoms that are more difficult to spot – and we need appropriate training for GPs and our teams to use them effectively.'
