Intended for healthcare professionals

Letters Self referral for cancer tests

Will self referral for cancer tests result in better mortality outcomes or yet more activity among the worried well?

BMJ 2015; 350 doi: (Published 05 February 2015) Cite this as: BMJ 2015;350:h562
  1. Kit Byatt, consultant general physician and geriatrician1
  1. 1Wye Valley NHS Trust, Hereford HR1 2ER, UK
  1. cbyatt{at}

I heard the news about self referral for cancer tests on the radio, and my heart sank. Having read your detailed account,1 I am not reassured.

A key problem is confusing the three related, but very different, concepts: survival, disease specific mortality, and overall mortality. Conflate these with changing the paradigm from investigating relevant symptoms after initial assessment by a clinician (the acknowledged world …

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