Diagnosis delayed for certain cancers and certain patients

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A large study conducted in the United Kingdom uncovered a wide variation between cancer types in the proportion of patients who had visited their general practitioner (GP) 3 times or more before being referred to the hospital for cancer diagnosis. The data also revealed that women, young people, and nonwhites are less likely to be referred before completing at least three visits with their family doctors. 


The analysis focused on 41,299 patients (representing 24 different cancers) participating in the 2010 National Cancer Patient Experience Survey in England. Half the patients who eventually received a diagnosis of multiple myeloma (939 of 1,854 [50.6%]) had three or more visits with their GPs before receiving a referral. Many persons in whom pancreatic cancer was eventually diagnosed also had three or more visits to their primary care provider before being referred to the hospital for diagnosis (193 of 467 [41.3%]).


In contrast, only 7.4% (625 of 8,408) of patients with breast cancer and 10.1% (113 of 1,124) of those with melanoma made three or more prereferral visits to the GP. 


Georgios Lyratzopoulos from Cambridge University, Cambridge, United Kingdom, and coinvestigators also reported in The Lancet Oncology that study participants with a subsequent diagnosis of stomach cancer or lung cancer were among those more likely to have made three or more prereferral visits, whereas men with testicular cancer or women with endometrial cancer were more likely to have been referred to the hospital for diagnosis after only one or two consultations with a GP.


Patients aged 16 to 24 years were found to be more than twice as likely as those aged 65 to 74 years to have three or more prereferral GP visits. The only cancers without an apparent age gradient were testicular cancer and mesothelioma.


Women were less likely than men to be referred quickly for diagnosis, particularly when bladder cancer was the diagnosis. Asians and blacks were less likely than whites to be sent to the hospital after just one or two visits with the GP.


These findings may help health care professionals prioritize early-
diagnosis initiatives based on particular cancers and sociodemographic patient characteristics. ONA

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