Diagnosing cancer in English community pharmacies

Cancer is diagnosed at more advanced stages, and consequently with poorer outcomes, in the UK than in many other high income countries.1234 Although these disparities have been observed over decades, worsening access to general practice appointments, particularly since the coronavirus pandemic, has led to concern that people with cancer symptoms are experiencing additional delays to diagnosis. Achieving timely diagnosis for many cancers is crucial to improving outcomes as even relatively short delays are associated with reduced likelihood of survival.5

Involving community pharmacy in detecting symptomatic cancer has long been proposed as a means of expediting diagnosis.6 In 2022 England’s NHS announced ambitious plans to enable community pharmacists to arrange tests for possible cancer symptoms,7 although the ongoing pilot schemes have adopted a more limited approach.8 Managing people presenting with possible cancer is not straightforward, and community pharmacies already struggle to meet high levels of demand. Even if substantially increased numbers of cancer referrals are made through community pharmacy, it will not solve the problem of delays for diagnostic services. It therefore seems unlikely that involving community pharmacy will transform how cancer is diagnosed in primary care.