Clinical update

Suspected cancer

One in two people will be diagnosed with cancer in their lifetime, says Cancer Research UK, and it is responsible for more than a quarter of all deaths in the UK

Essential facts

One in two people will be diagnosed with cancer in their lifetime, says Cancer Research UK, and it is responsible for more than a quarter of all deaths in the UK. An estimated 5,000 lives could be saved each year in England if cancer diagnoses were made earlier.

Picture credit: REX

In June, the National Institute for Health and Care Excellence (NICE) published updated and redesigned clinical guidelines to support GPs to recognise the signs and symptoms of 37 different cancers. In a change to its predecessor published a decade ago, recommendations are now organised by a patient’s symptoms and investigation findings, as well as the site of suspected cancer.

The overall aim is to make it easier for GPs to refer people for the right tests more quickly.

More than 200 different types of cancer exist, each with different symptoms, methods of diagnosis and treatment. Patients often present at primary care with symptoms that are non-specific, says NICE. As GPs see an average of just eight new cancer cases each year, signs may not be clear or obvious. The new guidance focuses on symptoms a patient may experience and see their doctor about, with clear tables that link signs and symptoms to possible cancers. The guidance gives GPs more freedom to quickly refer patients with worrying symptoms.

In its report, published in autumn 2014, Cancer Research UK said that almost half of all people who get cancer are diagnosed late, making treatment less likely to succeed. While the figures have improved, the UK still has one of the worst records in Europe for both identifying and surviving cancer, says the charity. A survey for the NHS in 2013 suggested that a quarter of all patients eventually diagnosed with cancer in England had to visit their GP at least three times before being referred for tests.

The best way to treat cancer successfully is to make an early diagnosis, says NICE. The sooner the disease is identified, the more likely treatment is to be effective. In cases where cancer is confirmed, patients should not have to wait longer than 31 days from when the decision is made to treat them to when the treatment begins.

Expert comment

Cathy Hughes, nurse consultant gynaecology/oncology, Imperial College Healthcare NHS Trust

‘The new guidelines are welcome and it is time that they were updated, as the previous ones were ten years old. There has been a lot of GP input into the guidelines, so they come from a primary care perspective. They will help anyone who sees patients with a red flag cancer symptom, including nurses. The aim is to achieve earlier diagnosis, which means that we will see more false alarms, but potentially we will pick up more cancers at an early stage.

‘The next big push will be for GPs to be able to order more diagnostic tests themselves, but it is not quite established yet across the country and I am not sure how many GPs can actually do it in practice.’

Find out more

NICE guidance on suspected cancer: recognition and referral (June 2015)

Oncology Nursing Society

Department of Health policy on cancer (March 2013)

Be Clear on Cancer campaign

Cancer Recovery Foundation UK

World Cancer Research Fund

Macmillan Cancer Support

Cancer Research UK

Marie Curie Cancer Care

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