The deadly delays over cancer tests
PATIENTS are far less likely to be referred by GPs for urgent cancer tests in Britain than in other Western countries, research reveals.
The delays directly affect survival rates, resulting in patients dying earlier in the UK than in Scandinavia, Australia and Canada.
GPs in those countries are up to five times more likely to send patients for cancer scans and X-rays, the Oxford University study found.
The situation is made worse by NHS waiting times, which are up to four times longer for some vital tests than in other countries.
This means that even once referred, patients can still wait a month for diagnosis, by which time tumours may have spread to other organs and the bones.
Rather than referring patients for tests, GPs in Britain were
more inclined to prescribe antibiotics or inhalers for those with a persistent cough, a symptom of lung cancer.
They tended to tell patients with bowel cancer symptoms to change their diet, prescribe painkillers or just say there was nothing they could do.
The findings, published in BMJ Open, prompt concern that lives are being lost because GPs are reluctant to refer patients for expensive tests if there is only a very small chance they have cancer.
For years, data has persistently shown that cancer survival rates in Britain are lower than other countries in the Western world even though our healthcare systems are similar. Although experts have speculated this was because GPs are not send-ing patients for tests, this is the first study to highlight the extent of the problem.
Sara Hiom, director of early diag-nosis at Cancer Research UK, which funded the study, said that GPs’ role as ‘gatekeepers’ for vital cancer checks needed to be urgently reviewed if patients are not being referred speedily.
‘GPs have a difficult job to do. They have to ensure those who need specialist tests get them, without overloading a health sys- tem that’s already strained,’ she said. The study involved 2,795 GPs from 11 countries and regions, including the UK, Denmark, Swe-den, Canada and Australia. The doctors completed a questionnaire asking them what they would do in various scenarios.
Only one GP in ten in the UK who saw a 62-year- old heavy smoker with breathlessness would send him for chest X-rays or scans to check for lung cancer, compared with two in ten in Denmark and Australia, and five in ten in Canada.
Fewer than four in ten GPs in the UK would send a 53- year- old woman for tests for ovarian cancer if she was complaining of irregular periods and abdominal pain, com-pared with six in ten in Australia and seven in ten in Canada.
GPs point out that cancer is very difficult to diagnose, and symp-toms of lung, bowel and womb can-cer can easily be mistaken for other long-term health problems.
They say that of the thousands of patients they see each year, an average of eight will turn out to have any form of cancer.
Researchers also blame the struc-ture of the NHS, which means fam-ily doctors cannot easily ask the advice of more specialist hospital doctors. GPs also say they are often deterred by budget-wary NHS managers from referring patients for expensive X-rays, CT scans and other checks which will probably prove unnecessary.
The findings also show that wait-ing times for scans in the UK are nearly four times longer than else-where in the world. Patients face delays of almost five weeks for ultrasounds – used to diagnose ovarian cancer – compared with less than two weeks in Australia.
Study lead author Dr Peter Rose said: ‘These striking findings are the first to identify factors in primary care that could be contrib-uting to international differences in cancer outcomes.’
The Department of Health said: ‘Early diagnosis is crucial to beat cancer. We are urging GPs to make sure people with symptoms are referred as quickly as possible.’
Sean Duffy, national clinical direc-tor for cancer at NHS England said: ‘This paper, which identifies some key factors that could lead to earlier diagnosis, supports our major programme of work to test innovative ways to diagnose cancer more quickly.’