Now, the National Institute for Health and Care Excellence (NICE) is updating its guidance to better support GPs and other primary healthcare professionals, and ultimately improve early diagnosis rates.
Nearly 1 in 2 people will develop cancer during their lifetime. Despite this, in October last year, the Organisation for Economic Co-operation and Development (OECD) said that countries are not doing as well as they could to diagnose and treat cancer, including the UK.
Professor Mark Baker, NICE’s clinical practice director, said part of the problem is that symptoms can easily be dismissed as less serious, but more common illnesses: “The problem is that a lot of cancer symptoms can be very general and similar to those of other conditions.
“For example, many people who smoke have a cough associated with chronic lung disease. These are the same people most likely to develop lung cancer, but may well dismiss their symptoms as ‘normal for them’.
“Unless it is a cancer-related sign or symptom that we are very familiar with – a lump in the breast for instance – many people won’t even think about the possibility of cancer.”
Professor Baker continued: “It is not always easy for GPs to spot cancer either. There are more than 200 different types of the disease so it is unrealistic to expect them to know every single sign and symptom of each one, especially when they only see a handful of new cases a year.
"Research carried out in general practice in recent years gives us better evidence about which signs and symptoms best predict cancer, and all this is captured in our updated guidance.
“We are updating our guideline to make things as simple as possible for GPs to consider the possibility of cancer and refer people to the right service at the right time.
“Early referral and diagnosis can help save lives.”
The draft guideline, which is now subject to a public consultation, uses tables to clearly set out which symptoms could be linked to which cancers and provides clear recommendations for tests and referral to specialist services.
It also sets out 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 and signs.
NICE hopes this ‘symptom based approach’ will help GPs facilitate quicker and more effective referrals to hospital. The Institute’s ‘Information for the public’ booklet will also be updated to help people identify possible signs of cancer and encourage them to visit their GP sooner.
The draft update of the NICE guidance also includes a series of new and updated recommendations about:
- ‘safety netting’: how and when to review people with any symptom associated with an increased risk of cancer who do not meet the criteria for referral, to ensure cancer is not missed.
- how best to reassure, support and inform patients with suspected cancer and their families, including those who fall into the ‘safety netting’ group.
Sara Hiom, Cancer Research UK’s director of early diagnosis, said: “We’re pleased that NICE is updating its guidelines to make it easier for GPs to refer patients with worrying symptoms for further tests. This means more cancers should be diagnosed as early as possible when treatment is most likely to be effective.
“We know it’s not easy for GPs to deal with symptoms where they have a sense that things aren’t right but no procedure to follow to arrange further tests. These guidelines should give them more options to get patients referred quickly. But to be truly effective doctors need better access to diagnostic tests and speedy results.
“We look forward to working with NICE, GPs and the Government to make earlier diagnosis of cancer a reality. This will help us realise our ambition to see three-quarters of people surviving the disease within the next 20 years.”
NICE’s public consultation on the draft guideline will run until Friday 9 January 2015. The Institute is encouraging all relevant patient groups and organisations, including local Clinical Commissioning Groups (CCGs) and other GP-led bodies, to register an interest in the guideline and submit comments via the NICE website during this consultation period.
For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.
Notes to Editors
Explanation of terms
- Research published in 2009 suggested that up to 10,000 people in England could be dying every year because their cancer was diagnosed late
About the guidance
- The final updated guidance is expected to be published in May 2015.
- The original guidance on referral for suspected cancer, published in 2005, is available on the NICE website.
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.
- Official figures show that a quarter of all people eventually diagnosed with cancer in England had to visit their doctor at least 3 times before being referred to hospital for tests.
- 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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