Symptom-based guidance for cancer diagnosis may save thousands of lives
A pan-European study published in 2013 examined the rates of patients’ survival for five years following the diagnosis of cancer. It found that there had been a steady increase in survival in all countries over the years, but that for a number of cancers the UK and Ireland had lower five year survival rates than the European average. The researchers attributed this largely to delays in both diagnosis and the use of diagnostic tests. In June 2015 the National Institute for Health and Care Excellence (NICE) published an updated guideline for general practitioners (GPs) that focuses on the signs and symptoms of 37 different cancers that people might go to their doctor with, so that the right tests can be performed faster. It covers:
- Abdominal symptoms
- Bleeding
- Gynaecological symptoms
- Lumps or masses
- Neurological symptoms
- Pain
- Respiratory symptoms
- Skeletal symptoms
- Skin or surface symptoms
- Urological symptoms
- Non-specific symptoms of cancer
NICE has provided information for the public about the guideline and the signs and symptoms that can sometimes be due to cancer. It is hoped that people with symptoms will visit their GP more quickly for a check-up and any tests that may be needed.
The tests that GPs can request to investigate symptoms include X-rays, ultrasound examinations and CT scans. Lab tests included in NICE guidance pathways for the diagnosis of some cancers include a full blood count (FBC), erythrocyte sedimentation rate (ESR) or plasma viscosity, protein electrophoresis, serum calcium, cancer antigen 125 (CA-125), prostate-specific antigen (PSA) and faecal occult blood (FOB).
The GP check-up and test results may mean that referral to a cancer specialist is indicated. NICE points out that very few people who are referred to a specialist actually have cancer, but that spotting cancer early can mean treatment is more likely to be successful. Health experts predict earlier diagnosis may save thousands of lives each year.
Willie Hamilton, Professor of Primary Care Diagnostics at the University of Exeter Medical School said ‘This guideline is about getting the right patients to the right tests at the right time’.