Policy briefing

NICE quality standard on suspected cancer

New guidelines published by NICE look to improve standards of care in cancer diagnoses.

New guidelines published by NICE look to improve standards of care in cancer diagnoses

Early diagnosis for people who have cancer can lead to improved survival rates
Picture: Science Photo Library 

Essential information 

Nurses must encourage patients with suspected cancer to attend tests to improve early diagnosis rates, says official guidance from the government agency tasked with setting clinical standards. 

Patients should be given written information explaining the importance of attending the appointment to avoid delays to their care.  

This is one of four quality standards published by the National Institute for Health and Care Excellence (NICE) to improve the care of those with suspected cancer. 

UK diagnoses

About a third of the population will develop a cancer in their lifetime and more than 300,000 new cancers (excluding skin cancers) are diagnosed annually in the UK. Early diagnosis with cancer can lead to considerably improved survival rates. For example, more than 90% of women diagnosed with breast cancer at the earliest stage survive their disease for at least five years compared to around 15% for women diagnosed with the most advanced stage of disease, Cancer Research UK says. 

Around one in four cancers in the UK are diagnosed through emergency admission to hospital, according to The National Cancer Intelligence Network (NCIN) data from 2010. Most patients diagnosed in this way have lower chances of survival compared to other patients. 


NICE warns there is considerable variation in both referral and testing rates for suspected cancer across the UK, which cannot be fully explained by variation in the population. 

The quality standards call for practice nurses and GPs to offer patients with symptoms that suggest colorectal cancer, who do not meet the referral pathway criteria, a test for blood in their faeces. Tests for the presence of blood are relatively easy, inexpensive and safe and help to identify people at higher risk of having colorectal cancer. 

NICE also calls for GPs to have direct access to diagnostic tests and for people presenting in primary care with symptoms which suggest oesophageal or stomach cancer to have an urgent, direct-access upper gastrointestinal endoscopy. 

Expert comment 

Dee Sissons, Marie Curie director of nursing

‘Early diagnosis is crucially important as it can save lives. I was a lung cancer nurse specialist, so I know all too well that this can be the difference between being able to provide patients with curative treatment rather than palliative care.

'Although the guidance talks specifically about the need for practice nurses to offer information and direct patients towards screening, every contact counts and all nurses can and should do more to encourage early diagnosis when they see an opportunity to.

'While this quality standard helps by raising awareness among primary healthcare professionals and supports GPs to encourage diagnosis among more of their patients, nurses must continue to raise public awareness and get people talking about cancer.’ 


Implications for nurses 

Give people with suspected cancer written information when they are referred to a cancer service, encouraging them to attend and explaining the need to do so. Reassure patients that most people who are referred will not be diagnosed with cancer.  

Offer adults testing for blood in faeces to assess for colorectal cancer if they do not have rectal bleeding but are over 50 with unexplained abdominal pain or weight loss, or under 60 with changes in their bowel habit or iron-deficiency anaemia.

Those over 60 and who have anaemia even in the absence of iron deficiency should also be offered a test. 

Further information

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