Viewpoint: GPs should judge what is 'appropriate' when testing for cancer

Yorkshire GP Dr Nick Summerton, a DH adviser on diagnostics, tells GPonline.com why he believes GPs should have the final say on ordering ovarian cancer tests, as pathologists defend restrictions on GP access.

Dr Nick Summerton: GPs should be allowed to judge if an ovarian cancer test is needed (Photo: UNP)
Dr Nick Summerton: GPs should be allowed to judge if an ovarian cancer test is needed (Photo: UNP)

There was a similar issue around brain natriuretic peptide (BNP) testing in the past and, with colleagues, we reviewed the evidence and did a proper 'appropriateness study' with GPs.

The real issue here for me is who judges what is 'appropriate testing' - the lab, in isolation from the patient and the primary care evidence, or the GP, in discussion with the patient and with an awareness of the primary care-oriented evidence? I would argue for the latter!

The labs also need to remember that CA125 is a triage test, not a definitive test - the next step in the processing pathway is transvaginal ultrasound.

The Royal College of Pathologists' comment about screening is interesting. They are clearly unaware of the effect taking a family history has on the prior probability of ovarian cancer, and hence the arguments for screening in the context of a strong breast/ovarian family history.

But, of course, my pathology colleagues don't see patients!

Read more about the restrictions:

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Subject access requests to GP practices increased by a third under GDPR

Subject access requests to GP practices increased by a third under GDPR

The number of subject access requests (SARs) GP practices receive each month has...

RCGP criticises GP at Hand video showing antibiotics prescribed for sore throat

RCGP criticises GP at Hand video showing antibiotics prescribed for sore throat

A promotional video for Babylon GP at Hand that shows a patient with a sore throat...

Review into overprescribing aims to give GPs power to challenge hospital scrips

Review into overprescribing aims to give GPs power to challenge hospital scrips

A government review of overprescribing in the NHS could see GPs given more power...

Submit your session ideas for the RCGP Annual Conference 2019

Submit your session ideas for the RCGP Annual Conference 2019

GPs can now submit ideas for sessions at the RCGP Annual Conference in Liverpool,...

Scottish GP workforce increases for first time in 10 years, figures show

Scottish GP workforce increases for first time in 10 years, figures show

GP numbers in Scotland have risen slightly for the first time in 10 years despite...

More than 16m GP practice appointments a year lost to DNAs

More than 16m GP practice appointments a year lost to DNAs

More than 16m appointments at GP practices are lost every year because patients fail...