8 May 2012

Take a 'Three-Strike' Approach to Teen Cancer Diagnosis, says Charity

GPs should refer teenagers for further investigation after their third visit if they have presented with repeated symptoms of cancer, a charity says.

Research from the Teenage Cancer Trust reveals that a quarter of young people visited their GP four times or more with common cancer symptoms, such as pain, a lump or extreme tiredness, before they were referred to a specialist.

Furthermore, the survey of 300 young cancer patients aged between 13 and 24 found that 61 per cent of young people visited their GP with at least one of the most common cancer symptoms, and yet 28 per cent of GPs took no action.

A number of GPs also misdiagnosed symptoms as an infection or virus, a sports injury, or even that the symptoms were a means of 'attention seeking'.

Making a diagnosis of cancer in children and teenagers is difficult, so NICE advises that GPs listen carefully to parents as they are usually the best observers of their children.

NICE's clinical guideline on referral for suspected cancer recommends that if a child or young person presents several times, for example three or more times, with the same problem, but with no clear diagnosis, then urgent referral should be made.

It is this "three strikes" approach to diagnosis that the Teenage Cancer Trust is now calling for.

GPs should also be willing to reassess an initial diagnosis, seek a second opinion from a colleague if a child fails to recover as expected, and continue to take part in education, peer review and other activities to improve and maintain diagnostic skills.

Simon Davies, Chief Executive of the Teenage Cancer Trust, said: "We are promoting the principle that after making three visits to a GP for persistent symptoms, they should then be referred for further investigation. That might be referral of further tests."

Mr Davies also said that there should be a greater number of resources provided to GPs to help them improve and speed up cancer diagnosis in teenagers.

"We are calling for more diagnostic aids to be introduced generally for GPs. These could be electronic diagnostic aids, or they could be tools brought in from hospitals.

"We would also like to see more links between primary and secondary care and for GPs to receive more diagnostic training,"  he added.