Study reveals variation in how quickly doctors refer suspected cancer patients

In collaboration with the Press Association

The speed GPs refer people with suspected cancer to hospital depends on the patient's age, sex, ethnicity and the type of cancer, according to new research.

Overall, more than three-quarters of people who go to their GP with suspicious symptoms are referred after only one or two consultations.

But some groups - women, young people, non-white patients, and those with some less-common cancers - frequently have to see their GP three or more times.

The findings, published in The Lancet Oncology, are from the Cancer Patient Experience Survey, which investigated data from more than 41,000 patients treated at 158 hospitals across England.

The study reveals large differences in how quickly GPs in England spot the signs of different cancers and refer their patients for further tests.

It found that patients who went to their GP with possible symptoms of multiple myeloma, or lung or pancreatic cancer, were referred less quickly than patients with more common cancers such as breast and testicular cancer or melanoma.

About half of patients with multiple myeloma - a type of blood cancer - needed multiple GP visits compared with just 7.4 per cent of patients with breast cancer.

The authors suggest that reasons for delayed recognition are down to differences in symptoms, which make some cancers harder to diagnose.

Cancers with well known signs and symptoms, such as changes to moles (melanoma) or an obvious lump (breast cancer), were more readily referred to hospital, suggesting they are more easily spotted as signs of cancer.

Younger patients and those from ethnic minorities were also more likely to have had several GP consultations.

According to the authors, this could be because GPs are less likely to consider cancer in young people, and possible communication difficulties with patients from different ethnic groups.

Lead author Dr Georgios Lyratzopoulos, of Cambridge University, said the findings highlighted limitations in current knowledge of cancer symptoms.

"Medical research in recent decades has prioritised improving cancer treatments, but knowledge about the 'symptom signature' of common cancers, and practical solutions on how best to diagnose them is still emerging".

Jessica Harris, health information manager at Cancer Research UK, said the study highlighted the difficulties GPs face in diagnosing cancer.

"A GP will see only around eight cases of cancer a year, on average, among hundreds of people with symptoms that might indicate cancer. So making appropriate referral decisions can be challenging, especially for rarer cancers or those with symptoms that are vague or common to other diseases," she said.

The National Awareness and Early Diagnosis Initiative, an initiative Cancer Research UK is involved with, is working hard to achieve earlier diagnosis of cancer, she added.

"But it's also very important for people to get to know their body and what is normal for them, and go to see the GP if they notice any persistent or unusual change. And do go back if your symptom has changed, not gone away or got worse."

Copyright Press Association 2012


  • Lyratzopoulos, G. et al. (2012). Variation in number of general practitioner consultations before hospital referral for cancer: findings from the 2010 National Cancer Patient Experience Survey in England The Lancet Oncology DOI: 10.1016/S1470-2045(12)70041-4