Intended for healthcare professionals


New guidelines for urgent referral of patients with cancer

BMJ 2000; 320 doi: (Published 27 May 2000) Cite this as: BMJ 2000;320:1476

Patients will have a dignified end to life

  1. Nick Summerton, general practitioner (
  1. The Surgery, Winterton, Scunthorpe DN15 1PN
  2. East Sussex Health Authority, Epsom KT19 8PH
  3. Department of Public Health, Merton, Sutton and Wandsworth Health Authority, Mitcham CR4 4TP

    EDITOR—Any new policy initiative such as the Department of Health's new guidelines for urgent referral of patients with cancer is inevitably accompanied by the views of both iconoclasts and opportunists. Sikora has clearly expressed his view, but I believe he is wrong.1

    As a general practitioner I am in a different position from Sikora. Patients do not arrive at my surgery with diagnoses and neatly typed referral letters; they arrive with often vague and undifferentiated problems. My task is to identify which patients with, for example, persistent cough warrant an urgent referral or radiography. Tertiary care specialists may often approach lymphadenopathy with biopsy; in general practice we need to adopt a watchful waiting approach.

    Sikora may be correct in stating that there is no evidence that delay in diagnosis is a large problem in the United Kingdom. However, a lack of evidence is surely an opportunity for further research.

    The guidelines are merely an attempt to identify evidence for the diagnosis of cancer that …

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