Fresh pair of eyes may speed up cancer diagnosisBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2232 (Published 27 April 2015) Cite this as: BMJ 2015;350:h2232
Researchers have found that symptoms of bowel cancer tended to be identified slightly more quickly when patients consulted an unknown doctor rather than their usual GP.1
The study, published in the British Journal of General Practice, included data for 2000 to 2009 from the General Practice Research Database. The study included around 18 500 patients with breast, bowel, or lung cancer whose relevant cancer symptoms or signs were identified up to 12 months before the eventual diagnosis.
Having the same doctor in the 24 months before diagnosis was associated with a slightly later diagnosis of colorectal cancer (time ratio 1.01 (95% confidence interval 1.01 to 1.02)) but not of breast or lung cancer. However, the maximum delay was small, at around seven days. Although seeing a known GP may slightly delay diagnosis, following up new worrying symptoms with the same doctor was found to result in a quicker diagnosis of around 14 days for colorectal cancer and 18 days for lung cancer. The time to diagnosis of breast cancer was not affected by whether the patient saw the same doctor either before or after potential cancer symptoms were identified.
For all cancers the most significant factor predicting earlier diagnosis was time of first presentation with a high risk symptom or sign, and the greatest delay in diagnosis of all three types of cancer occurred after the patients had been referred.
The authors said that GPs should be cautioned against overlooking potentially worrying symptoms or signs among patients whom they know well. Doctors may misattribute new complaints to ongoing problems or personality traits, leading to delayed or missed diagnosis.
The study’s leader, Matthew Ridd, a GP and senior lecturer in primary care at the University of Bristol’s Centre for Academic Primary Care, said, “These findings provide some evidence that GPs should follow up patients who present with potential cancer symptoms to make sure they receive a timely diagnosis. But interestingly we also found that your regular doctor might not be the best person to spot those symptoms in the first place. So in some cases getting a second opinion from a different doctor could speed up the time to diagnosis.”
Richard Roope, a GP in Hampshire and an adviser to the charity Cancer Research UK, said, “Many people prefer to have a single family doctor, but these intriguing findings suggest that in some cases a fresh pair of eyes could be better at spotting early signs of cancer.”
Cite this as: BMJ 2015;350:h2232