One in 2 people will be diagnosed with cancer in their lifetime. The disease is responsible for more than a quarter of all deaths in the UK; for many terminal cancer cases this will be due to a late diagnosis.
The National Institute for Health and Care Excellence (NICE) has updated and redesigned its guideline to support GPs and other primary care professionals to recognise the signs and symptoms of cancer and refer people for the right tests faster.
It has also produced information to help the general public recognise the most common possible signs of cancer so that people can visit their doctor sooner.
Professor Mark Baker, clinical practice director at NICE, said: “The best way to successfully treat cancer is to make an early diagnosis. The sooner the disease is identified, the more likely treatment is to be effective. Earlier diagnoses have the potential to save thousands of lives each year.
”What we would ideally like to see is more people acting quickly and seeing their doctor when they notice a particular change to their body, and GPs referring those people in the right direction for tests.”
In a change to its 2005 predecessor, the updated guideline uses a new approach – focusing on the symptoms that a patient might experience and go to their doctor with - to make its recommendations easier for GPs to use. It sets out clear tables linking signs and symptoms to possible cancers and includes simple recommendations about which tests to perform and the type of referral to specialist services that should be made.
NICE says this will make it easier for GPs to think about the possibility of cancer sooner and refer people for tests quicker. This in turn will mean more people receive an early diagnosis and subsequently, more cancers could be cured.
Professor Willie Hamilton, Professor of Primary Care Diagnostics at the University of Exeter who helped to develop the updated guideline, said: “When you look at the statistics, Britain is lagging behind other countries in terms of cancer survival and one of the big reasons for this is late diagnosis.
“In my experience I would say that late diagnosis alone is responsible for thousands of deaths every year. This updated guideline will help to change that. It will open the door for smarter testing so that people with cancer will receive their diagnosis much earlier. There is no doubt in my mind that this guideline will help to save lives.”
Research published in 2009 estimated that up to 10,000 lives in England could be saved every year if the disease was diagnosed earlier and more appropriate surgery was used as the primary treatment. Meanwhile, a recent study looking at cancer survival rates across Europe found that the UK and Ireland have lower survival rates than the European average for kidney, stomach, ovarian, colon and lung cancers. The researchers attribute this mainly to delayed diagnosis.
The NICE guideline makes recommendations for children, young people and adults with suspected cancer. It sets out:
- Which signs and symptoms are associated with the most common types of cancer;
- Which tests should be performed according to the type of cancer suspected, and if they can be done in a GP surgery or hospital clinic;
- How long people should wait to be seen by a specialist once they have been referred to hospital. This ranges from 2 weeks to 48 hours or sooner, depending on the person’s signs and symptoms;
- How and when to review people with any symptom associated with an increased risk of cancer who do not meet the threshold for immediate referral, to ensure cancer is not missed. This is referred to as ‘safety netting’;
- Clear recommendations on the information and support which should be provided to people with suspected cancer and their families and/or carers.
Dr Steve Hajioff, a director of public health, chaired the independent group of experts which developed the guidance for NICE. He said: “Cancer is an incredibly common disease, which can leave death and heartbreak in its wake. There are more than 200 different cancer types and in excess of 300,000 people are diagnosed each year in the UK.
“This sounds like a lot, but GPs will only see a handful of patients with some form of cancer every year. With the disease sharing many symptoms with more common and much less serious conditions, this makes it even more difficult for doctors.
“No GP wants to miss a cancer diagnosis. This guideline will support them by encouraging them to think about the possibility of cancer sooner. Not only will it speed up the process of referral, enabling faster diagnosis, but its recommendations to monitor people with less severe signs and symptoms will mean fewer cancers are missed.”
David Martin was diagnosed with bladder cancer about 15 years ago and credits his early referral and diagnosis for successfully beating the disease: “I noticed one morning that I had blood in my urine. It was gone the next day and I don’t think such things should be ignored so though I should get it checked by my GP.
“If I hadn’t, it might have been some time before it reappeared and the cancer would have been more advanced and potentially more difficult to treat. I’m thankful that I chose to see my GP and that he quickly realised it might be serious and referred me on for specialist tests. It’s a major reason why I am still here today. An early referral can really help to make a difference.”
For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.
Notes to Editors
About the guidance
The updated guideline for the recognition and management of suspected cancer in children, young people and adults, and the corresponding information for patients, will be available at http://www.nice.org.uk/guidance/NG12 from Tuesday 23 June 2015.
Embargoed copies of the guideline are available from the NICE press office on request.
Facts and figures
- 292,585 people were diagnosed with cancer in England and Wales in 2011. This is according to data gathered by Cancer Research UK from the Office for National Statistics and the Welsh Cancer Intelligence and Surveillance Unit in June 2013.
- In 2012, there were estimated to be just over 14 million new cases of cancer worldwide.
- Cancer can develop at any age, but is more common in older people. More than a third of cases are diagnosed in people aged 75 and over. It is relatively rare in children and young people.
- More people are surviving cancer than ever before. About half of all patients diagnosed with a form of the disease in England and Wales live for at least 10 years.
For more cancer-related statistics, please visit Cancer Research UK: http://www.cancerresearchuk.org/cancer-info/cancerstats/
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