13 December 2011

Three Quarters of Patients With Cancer are Referred Within One Month, Reveals RCGP Report

Published by the RCGP’s Clinical Innovation and Research Centre (CIRC), the report – the first of its kind – describes the findings of the National Audit of Cancer Diagnosis in Primary Care, undertaken in 2009/2010 as part of the National Awareness and Early Diagnosis Initiative.

To date, it is the largest and most comprehensive study of the primary care pathway to cancer diagnosis, covering one in seven practices in England.

The audit examined intervals in the diagnostic pathway, looking at the primary care interval – defined as the time between first presentation and date of referral, and the referral interval – the period between referral and the date the patient first attended secondary care.

The report found that:

  • Three quarters (73.2 per cent) of patients visiting their GP were referred to a specialist after only one or two consultations.
  • Nearly 60 per cent of all patients referred (57.1 per cent) attended secondary care within two weeks.

The report also looked at use of investigations, and found that some cancer patients, including those with brain, ovary, pancreas, liver and kidney cancer, were more likely to have benefited from better Primary Care access to diagnostics including chest X-rays, non-obstetric ultrasounds, GI endoscopies and brain MRIs. Overall, rapid access to investigations would have altered the GP’s management of the patient in 6 per cent of cases.

Professor Greg Rubin, Professor of General Practice and Primary Care at Durham University and RCGP Project Lead for the Audit, said:

“This report provides the first detailed analysis of how GPs diagnose cancer. The good news is that many patients are identified promptly as needing specialist assessment, but we could do better and improved access to cancer tests would help in this.”

RCGP Chair Dr Clare Gerada said:

“This report shows that in General Practice we do a very good job of identifying our patients who have cancer, and in referring them quickly for specialist treatment.

“While there are groups of patients where we do, for various reasons, have difficulty in making a rapid diagnosis, we must be proud that the majority are being identified and put into secondary care quickly. At the same time, we must always be looking at how we can improve.

“The report confirms that the foundations that will enable us to continue to provide a quality service are already in place, and that they are the attributes of quality General Practice – continuity of care; patient centeredness and shared decision making; clinical acumen and sound diagnostic skills.”

Chris Carrigan, Head of the National Cancer Intelligence Network (NCIN), said:
“Collecting and evaluating data on how quickly cancer patients are sent for referral by their GP is crucial to equip us with the knowledge to improve early detection of the disease. This study allowed us to analyse data from the time a patient first visits the GP with symptoms to follow up tests at the hospital. But understanding and improving diagnosis, treatment and outcomes for patients is complex. These data give us one piece of a jigsaw puzzle but we need to continue to hunt for these pieces of data so that we can build a clear picture of where delays could be occurring. Early detection really is the key to improving survival rates in the country in order to bring England’s cancer survival in line with the best in Europe.”

Further information

RCGP Press office – 020 3188 7574/7575/7576/7569
Out of hours: 0203 188 7659
press@rcgp.org.uk

Notes

Data were collected on 18,879 patients by 1170 practices in 20 cancer networks.

The proportion of patients referred within 31 days was calculated by redistributing those for whom the primary care interval was not known even across the 6 time periods.

The Royal College of General Practitioners is a network of more than 44,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.