Cancer is diagnosed more quickly in patients who bypass GPs

Cancer is diagnosed more quickly in patients who bypass GPs

Delay in diagnosis of cancer in the United Kingdom varies widely, according to the type of cancer, new research shows. Patients with suspected prostate cancer face delays almost three times as long as those with suspected breast cancer, claims new research.

The study, which was published online (ahead of print publication) on 3 May in the British Journal of Cancer (www.bjcancer.com, doi:10.1038/sj.bjc.6602587), looked at times to diagnosis for six types of cancer. It showed that the average time to diagnosis of prostate cancer is 148.5 days, while that for breast cancer is 55.2 days.

Patients who did not see their GP first waited much less time for diagnosis, regardless of the type of cancer. Some patients bypass seeing their GP because they are already in hospital or because they are admitted to the emergency department.

"Reducing diagnostic delays with the intention of increasing the proportion of early stage cancers may improve cancer survival in the UK, which is poorer than most other European countries. Interventions aimed at reducing patient and primary care delays need to be developed and their effect on diagnostic stage and psychological distress evaluated," write the authors, from the University of Leeds and Wales College of Medicine.

The research compared different elements of delay in diagnosis (delay by the patient and delays in primary care, referral, or secondary care) for six types of cancer (breast, colorectal, lung, ovarian, prostate, and non-Hodgkin’s lymphoma) and compared delays in patients who saw their GP before diagnosis with those who did not.

The authors used data from completed questionnaires from 65 192 patients who took part in the national survey of NHS patients.

The mean overall times to diagnosis were 55.2 days for breast cancer, 88.5 for lung cancer, 90.3 for ovarian cancer, 102.8 for non-Hodgkin’s lymphoma, 125.7 for colorectal cancer, and 148.5 for prostate cancer.

A total of 52 079 patients (80%) said they had visited their GP before diagnosis, 12 074 (19%) reported that they had not, and 1039 (2%) did not answer this question. These percentages varied according to the type of cancer, with 27% of patients with breast cancer but only 10% of those with colorectal cancer not seeing their GP first.

Delays in referral and in secondary care were much shorter than delays in primary care and those caused by the patient. "Patients who saw their GP prior to diagnosis experienced considerably longer total diagnostic delays than those who did not," write the authors.

"The finding that patients who reported seeing their GP prior to diagnosis had longer delays was an unexpected finding. Patients diagnosed through screening bypass patient and primary care delays. Current UK policy aimed at earlier detection of cancer by reducing delays concentrates mainly on treatment and referral delays, although the evidence base for these policies has been questioned."