Among patients presenting to their general practitioner with ‘red flag’ features suggestive of possible cancer, 60% are not being referred for urgent investigation with a specialist within 2 weeks, contrary to guideline recommendations, shows a UK analysis.
Of the patients who were not given an urgent referral, approaching 4% were diagnosed with cancer within a year, compared with almost 10% who did receive a referral.
The researchers studied the records of nearly 49,000 patients who visited their GP with alarm features, including haematuria, a breast lump, difficulty swallowing, iron-deficiency anaemia, and postmenopausal or rectal bleeding.
They found that a patient’s likelihood of being given an urgent referral varied depending on what red flag feature they had, as well as on their age, whether they had comorbidities, and the clinician they saw and the practice they attended.
The relatively large proportion of patients who were not referred but went on to develop cancer “could mean an opportunity to diagnose the cancer earlier was missed”, said Lead Author Dr Bianca Wiering, University of Exeter Medical School.
If you want to read more, the research was published by BMJ Quality & Safety on October 4.