Wessex study highlights the importance of early cancer diagnosis
Although the patients had presented at their GP practice an
average of 8.2 times in the preceding two years their cancer was diagnosed
following an emergency attendance at one of the seven hospitals in the Wessex
- 54% of the
patients were diagnosed after going to A&E without being referred
- 30% of
patients were GP admissions direct to a speciality
were referred to A&E by their GP
The patients in the study were generally elderly and 83% had
pre-existing multiple health conditions. The appointments at their GP practice
were often for monitoring or conditions that had become worse.
Importantly, 39% had a previous A&E attendance with symptoms
that could be associated with their eventual cancer diagnosis, such as
abdominal pain, shortness of breath and weight loss.
The clinical outcomes for these patients were very poor. All
patients had died within one year of diagnosis. Of these, 49% had died within
31 days and 77% within 90 days of their cancer diagnosis.
Macmillan GPs reviewed the patients' primary and secondary care
notes for the preceding two years. The GPs were asked if there had been
potential opportunities for earlier diagnosis and/or any contributing factors
to the late diagnosis. The GPs reviewing the care notes recorded possible
opportunities for earlier diagnosis of cancer in 19 of 66 patients.
Their findings, which will be shared at the UK Oncology Nursing
Society Conference at Harrogate in November, included:
follow up of patients who miss appointments
- Training all
clinical staff involved in chronic disease management in cancer
Event Analysis of all emergency presentations of cancer at practice level
- A focus on
early detection of lung and bowel cancer
The study involved only a small number of patients and although
these results only provide a 'snapshot' across the region, they correlate with
findings from a much larger London Cancer Study undertaken in 2013.