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Cancer study highlights importance of GP care.


Thousands of people diagnosed with cancer in A&E departments every year have visited their GP three times or more with symptoms, research has shown.

A study has found that 71 per cent of all patients diagnosed in A&E departments had seen their GP at least once with symptoms that turned out to be cancer. The remainder had never visited their GP.

Of the group that did see their GP with symptoms, 41 per cent had sought help three or more times while 59 per cent had seen their GP once or twice.

Some of these had difficult-to-spot cancers, such as lung cancer or multiple myeloma, and tended to be younger or female.

But the group also included people with common cancers such as breast cancer. The study found that 31 per cent of patients with breast cancer had visited their GP three or more times, 41 per cent with bowel cancer had visited three or more times, and 37 per cent with prostate cancer had visited three or more times.

People diagnosed with cancer as an emergency have a worse prognosis than those diagnosed at an earlier stage. The quicker a cancer patient can get a diagnosis, the better their treatment options.

The study, said to be the most comprehensive of its kind, was published in the British Journal of General Practice. The authors, from University College London, the University of Cambridge and Public Health England, analysed 2010 data from 4,637 people diagnosed in A&E.

They found that patients who had never been to their GP tended to be older, male and living in the most deprived regions of England.

Patients in A&E diagnosed with common cancers, who had visited their GP three or more times, could have been presenting with unusual symptoms, the authors said.

A previous study, found that patients who saw a GP three or more times before being referred for cancer tests were more likely to be dissatisfied with their overall care and had less confidence in the doctors and nurses who eventually treated them.

A lead researcher at UCL, Dr Georgios Lyratzopoulos, said: “These findings tell us that some patients diagnosed as an emergency might not be acting on ‘red flag’ symptoms which could have prompted them to visit their GP.

“A host of other factors may also be at play. For example, many elderly patients may find it difficult to get to the surgery or have other conditions that would prevent them from seeking an appointment, such as dementia.

“This highlights the need to explore all the reasons why cancers are diagnosed late, including what happens outside GP surgeries. It also shows that late diagnosis is more complex than it’s often presented to be, as there are multiple reasons why cancers are spotted late.”

Kim Daniells of the CNCI team commented, "this is an important study. Although screening programmes offer an opportunity to spot cancers at an early stage, they are not available for all cancers. It is critical that primary carers, GPs, respond appropriately to individuals reporting with red flag or persistent symptoms. Patients who are falsely reassured may fail to seek advice about further symptoms because they fear wasting the doctor's time. For many cancers, early diagnosis offers more treatment options and a better prognosis and ensuring that patients with significant symptoms are able to access diagnostic tests is critical".





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