Survival outcomes for cancer depend on how quickly symptoms are acted upon. This fact makes a new report on the state of patient referrals in England devastating. The research, published in the journal BMJ Quality & Safety, found just 40 percent of people with “red flag” symptoms were urgently referred to a cancer doctor in 2015.
This failure flies in the face of recommended guidelines, which say to refer people with suspected symptoms for a specialist assessment within two weeks.
Nearly four percent of these patients were subsequently diagnosed with cancer within the next 12 months.
To gather their findings, researchers analysed records from almost 49,000 patients who consulted their GP with one of the warning signs for cancer that should warrant referral under clinical guidelines.
They found that six out of 10 patients were not referred for cancer investigation within two weeks of the first visit.
READ MORE: Bowel cancer symptoms: What colour is your urine? Three colours that signal bowel cancer
The “red flag” symptoms included blood in urine, a breast lump, problems swallowing, iron-deficiency anaemia and postmenopausal or rectal bleeding.
The lowest referral rate was for problems swallowing, at just 17 percent, and the highest was for breast lump, at 68 percent.
“The number of patients who go on to be diagnosed with cancer when they are not urgently referred indicates that following the guidelines more strictly would have significant benefits,” the researchers wrote.
The lead author of the study, Dr Bianca Wiering, said: “It’s important to note that this issue does not just lie with GPs – we also need to ensure the services to provide the tests needed on referral are well resourced, which we know is currently not always the case.”
Prof Martin Marshall, chair of the Royal College of GPs, said: “GPs follow clinical guidance to ensure that referrals are appropriate and are sensitive to the risks of over-referring patients because this would risk overloading specialist services and would not be helpful to patients or the NHS.
“GPs find themselves in a position where they are criticised for referring both too much and too little: what would help is better access to diagnostic tools in the community and additional training to use them and interpret the results, so that better informed referrals can be made.”
According to the NHS, you should speak to a GP if you’ve noticed these changes and it’s lasted for three weeks or more:
- Tummy discomfort
- Blood in your poo
- Diarrhoea or constipation for no obvious reason
- A feeling of not having fully emptied your bowels after going to the toilet
- Pain in your stomach or back passage (anus).
There are over 200 different types of cancer that can cause many different symptoms but any unusual changes are worth getting checked out.
Cancer that’s diagnosed at an early stage, when it isn’t too large and hasn’t spread, is more likely to be treated successfully.
In England, more than nine in 10 bowel cancer patients survive the disease for five years or more, if diagnosed at the earliest stage.
There is a bowel screening programme in the UK for people without symptoms.
“You don’t need to wait for your screening invitation if you’ve spotted something that’s not normal for you. Take charge and speak to your GP,” advises Cancer Research UK.