GPS are missing opportunities to help diagnose cancer earlier in nearly 20% of North-east patients.
The findings, in the British Journal of Cancer (BJC), analysed 1,802 cancer patients from across the region in one of Scotland’s most detailed studies of emergency cancer presentation to date.
It revealed that 19% – almost one-in-five – of those patients could be viewed as “genuine missed opportunities for GPs to diagnose cancer earlier”.
In these instances, GPs either recorded zxa symptom which should have prompted concerns about cancer or led to specialist referral to investigate the issue.
Of those North-east patients who had previously flagged up symptoms to their doctor, 81% had been appropriately referred on by their GP for treatment or investigation.
Dr Miles Mack, chairman of the Royal College of General Practitioners in Scotland, said: “GPs across Scotland are desperate to secure funding in order to increase capacity and help the service to improve on the 81% of times they successfully identify cancers.
“We must ensure patients continue to have ready and direct access to a GP.
“Patients need to be seen as a whole person, by someone who knows and understands them and who has the knowledge to identify if and how they are unwell.
“It is regrettable that, particularly in its early stages, patients will present with non-specific symptoms and it is only by offering further appointments that a diagnosis will become clear.
“In other cases, best practice will mean patients require investigation in general practices prior to referral, which may result in a number of consultations.”
The study also revealed almost a third of North-east cancer patients diagnosed as an emergency last year did not flag up symptoms with their GP beforehand.
Researchers say the findings show more now needs to be done to improve public confidence in GPs, while ensuring medical practitioners have better access to tests and specialist advice to help diagnose cancer as early as possible.
Dr Peter Murchie, a GP and researcher at the University of Aberdeen, said: “It’s vital we do more to ensure people with persistent or unusual symptoms feel confident about getting them checked out by a doctor without delay.
“This study sheds light on the complications surrounding emergency cancer diagnosis and how quickly circumstances can change for the patient.
“And it’s equally important to give GPs better access to the tests and specialist advice they need to help them spot potential cancer symptoms at the earliest stage.”
Jodie Moffat, Cancer Research UK’s head of early diagnosis, said although emergency diagnosis will happen for some, an early diagnosis improves their outlook.
She said: “For some patients, emergency presentation may be difficult to avoid, but for others there are often things that could have been done differently.
“Studies like this help us to identify what needs to change.
“Cancer patients diagnosed as an emergency are more likely to have late stage disease and poorer survival.
“So it’s vital we do all we can to break down barriers to people visiting their doctor with symptoms that could be cancer.”
Cancer Research UK is now working with GPs to help improve early cancer diagnosis and ensure they have the freedom to refer patients for further tests and access specialist advice if cancer is suspected.
A spokeswoman for NHS Grampian said: “An early diagnosis offers the best chance of successful treatment and recovery from cancer, and we would strongly encourage people throughout Grampian to be vigilant and see their GP if they have concerns about cancer or spot any potential symptoms.
“We are committed to providing first class care and support for cancer patients and significant work is under way to further enhance services in Grampian, the proposed new ANCHOR cancer centre at Foresterhill being just one example.”
The BJC study, funded by the Scottish Chief Scientist’s Office, involved a detailed review of the case notes from patients diagnosed with cancer in Northern Scotland and registered at GP surgeries across NHS Grampian, Orkney and Shetland.
For each patient, the sequence of events leading to diagnosis was analysed, along with lifestyle characteristics as well as socio-demographic and other relevant information.
The study revealed almost half (44%) of patients had been sent straight to hospital by their GP after further tests revealed “red flag” cancer signs, with around a third (30%) admitted as emergencies while waiting for a hospital appointment.