One third of cancer cases in England diagnosed as emergency

More than one third (34 percent) of patients with cancer diagnosed as an emergency in England had not visited their GP beforehand, a Cancer Research UK funded study published in the British Journal of General Practice has found, which is hindering their chances of achieving the best treatment outcomes.

Looking at data from more than 4,600 patients with 18 different types of cancer, researchers based at UCL, The University of Cambridge, The University of Exeter and Public Health England found that among those who presented as an emergency, men, the elderly and people from more deprived backgrounds were more likely to have had no prior GP visits.

The study also found that 23 percent of patients had visited their GP three or more times before being diagnosed as an emergency, although some had cancers that are more difficult to identify, such as myeloma and lung cancer, which could be a reason for this.

Also, some people also had symptoms at a young age which can make a cancer diagnosis less likely because of its association with older people, or may have had symptoms that are more unusual, the study authors noted.

"These findings tell us that some patients diagnosed as an emergency might not be acting on ‘red flag’ symptoms which could have prompted them to visit their GP. There’s also a host of other factors that may be at play. For example, many elderly patients may find it difficult to get to the surgery or have other conditions which would prevent them from seeking an appointment, such as dementia," noted Dr Georgios Lyratzopoulos, one of the lead researchers based at UCL.

"This highlights the need to explore all the reasons why cancers are diagnosed late, including what happens outside GP surgeries. It also shows that late diagnosis is more complex than it’s often presented to be, as there are multiple reasons why cancers are spotted late."

Dr Julie Sharp, head of health information at Cancer Research UK, said the study shows that there are multiple reasons that can affect how and when a cancer diagnosis is made.

"We need to continue to increase awareness of cancer signs and symptoms and help break down the barriers preventing people from seeing their GP earlier, whilst GPs need better access to the right tests and referral routes if we want to see this number reduced," she stressed.

"In the last five years the proportion of cancers diagnosed as an emergency has dropped from 25 percent to 20 percent, and a higher proportion of patients are being diagnosed at an earlier stage of the disease," said Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, commenting on the findings.

"However, as this study shows, there are still some patients who seem to be missing or ignoring worrying symptoms until they are severe enough to send them to A&E. They are not seeing their family doctor at all, and are instead being diagnosed at a later stage as an emergency, which is known to reduce the chances of a good outcome."