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Skipping urgent referral linked to mortality risk

People with cancer who skip urgent referral appointments for their symptoms are more likely to die within a year of diagnosis, researchers say

People with cancer who skip urgent referral appointments for their symptoms are more likely to die within a year of diagnosis, researchers say

Pictures shows a GP talking to a young man. People with cancer who skip urgent referral appointments for their symptoms are more likely to die within a year of diagnosis, researchers say
Picture: Jim Varney

Patients with cancer who fail to keep an urgent referral appointment for their symptoms are 12% more likely to die within a year of diagnosis, a study has found.

Male patients and those aged under 30 or over 85 are more likely to skip their appointment, the study found, as are people living in disadvantaged areas and those referred due to gastrointestinal problems.

The NHS Two Week Wait policy aims to ensure that patients with suspected cancer are seen by a consultant within two weeks of an urgent GP referral.

Researchers at the University of York and Hull York Medical School looked at data from 100,000 patients who had been urgently referred by 100 different GP practices in the north of England over a seven-year period.

Implications for services and policy

While 95% of patients attended their referral appointment, 5% (5,673 people) did not.

The study found only one in 18 of the patients who skipped their appointment went on to be diagnosed with cancer – compared with one in ten of those who did attend – but the outlook for patients who missed their appointment and had cancer was significantly worse.

Some 34.6% of non-attending patients with cancer had an advanced stage of the disease at diagnosis compared with 18.4% of attenders with cancer.

The authors said having a more advanced stage of the disease is likely to be a reason why more non-attending patients with cancer died within a year of diagnosis – 31.3% compared with 19.2% of attenders. They said the study findings have implications for cancer services and policy.


Reference

Sheridan R, Oliver S, Hall G et al (2019) Patient non-attendance at urgent referral appointments for suspected cancer and its links to cancer diagnosis and one year mortality: A cohort study of patients referred on the Two Week Wait pathway. Cancer Epidemiology. doi: 10.1016/j.canep.2019.101588


Compiled by Dion Smyth, lecturer-practitioner in cancer and palliative care at Birmingham City University

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