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Views & Reviews No Holds Barred

Margaret McCartney: Early cancer diagnosis: how low should we go?

BMJ 2015; 351 doi: (Published 30 November 2015) Cite this as: BMJ 2015;351:h6442
  1. Margaret McCartney, general practitioner, Glasgow
  1. margaret{at}

Harpal Kumar, chief executive of Cancer Research UK, recently lectured at the Royal College of General Practitioners’ annual conference. My blood pressure rose steadily throughout.

He said GPs should ensure that 75% of our patients take up their invitations to cancer screening. He also said that the National Institute for Health and Care Excellence’s new threshold for cancer risk that should trigger referral (3%) may need to be lowered, as a recent study had found that patients at lower risk wanted to be investigated.1

But what is the “right” level of risk at which to investigate?2 Even if the computer tools slowly being introduced to estimate risk thresholds for symptoms are eventually shown to improve …

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