Early GP Referrals Lead to Longer Survival, Earlier Diagnosis for Patients with Cancer

An early referral from a general practitioner (GP) is likely to lead to longer survival for patients with cancer, according to a study published in the British Journal of General Practice.

The study found that patients of cancer from the highest referring GP practices had a lower mortality rate than those from the lowest referring GP practices. Even more, these patients were more likely to be diagnosed at an early stage of the disease for breast, lung and prostate cancer.

“The urgent referral, or two-week wait pathway, is very helpful for both patients, with potentially worrying symptoms, and their GPs who can fast track them to have a specialist review or tests, Dr. Thomas Round from King's College London and Public Health England said in a press release. “This research shows that GPs are referring substantially more patients with suspected cancer, which is making a real impact in improving cancer outcomes in the NHS."

The study used data from the National Cancer Registry to examine 1.4 million patients of breast, lung, prostate and colorectal cancer to determine its results. The research supports the increase in primary care referrals, which allows for more diagnoses of cancers.

Ultimately, if a GP suspects a patient might have cancer, they can fast track refer them to see a specialist within the two weeks after the initial visit. Because of this, urgent referrals have increased to over 2 million per year in England, with the average GP referring 50 to 60 patients annually.

This, coupled with the increases in primary care referrals and access to diagnostic tests, has led to cancer diagnoses after A&E presentations to drop from 1 in 4 to nearly 1 in 5, whose patients are more likely to have worse outcomes.

“It is important if patients are experiencing worrying symptoms to contact their GP practice,” said Round in a press release. “Whilst the assessments may be different, and NHS capacity is stretched, we are still trying to facilitate urgent two week wait referrals in collaboration with our hospital colleagues. With approximately 450 cancer deaths per day in the UK it's important that we continue urgent referrals, diagnosis and treatment for cancer patients."

One in every 2 patients in England will be diagnosed with cancer in their lifetimes, with 360,000 new cases and 165,000 cancer deaths per year in the United Kingdom. Early diagnosis, in part from GP referrals, is a key component to increasing cancer survival rates, which is higher in similar countries than it is in the United Kingdom. Overall, there are potentially 5,000-10,000 avoidable cancer deaths annually in the United Kingdom when compared to similar countries.

"Clearly the current COVID19 situation is putting a significant strain on health services, including for potentially serious conditions, such as suspected cancer referrals and cancer treatment once diagnosed,” said Round in a press release. “This is clearly a worrying time for patients and NHS staff. We have some reports of patients delaying seeking help because they think their GP practice or A&E departments are closed. This is not the case, with GP practices adapting with use of telephone, video and online appointments.”

Reference:

Early GP referrals are leading to cancer patients surviving longer [news release]. King’s College London. Published April 20, 2020. https://eurekalert.org/pub_releases/2020-04/kcl-egr042020.php. Accessed April 29, 2020.