Published 15 July 2009, doi:10.1136/bmj.b2815
Cite this as: BMJ 2009;339:b2815

Letters

Incidental lymphocytosis

Cancer targets not as rational as testing

The first 150 words of the full text of this article appear below.

Grove and colleagues advise general practitioners how to manage asymptomatic patients with incidental lymphocytosis and ultimately chronic lymphatic leukaemia, recommending repeat blood counts at 2-4 weeks and 3 months and then referral to a haematology clinic.1

This rational testing does not sit comfortably with the less rational cancer waiting times target that patients with a suspicion of cancer should be seen within 15 days.2 The suspicion of cancer in this case was extremely high from the outset but did not warrant urgent referral. Asymptomatic patients with monoclonal gammopathy are a similar example. These examples highlight ongoing clinical concerns with all inclusive cancer targets.

The lead cancer clinicians for the west of Scotland have expressed their concerns that cancer targets come both with a clinical cost and at the expense of audit of treatment and outcome.3 Yet clinical audit underpins cancer networks and is the key to service improvement. The delivery . . . [Full text of this article]

Edward Fitzsimons, consultant haematologist1, Heather Wotherspoon, network manager2

1 Western Infirmary, Glasgow G11 6NT, 2 West of Scotland Blood Cancer Managed Clinical Network, Glasgow Royal Infirmary, Glasgow G4 0SF

edward.fitzsimons@ggc.scot.nhs.uk


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