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 area:

54% of the patients were diagnosed after going to A&E without being referred

30% of patients were GP admissions direct to a speciality

13% 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:

Improving follow up of patients who miss appointments

Training all clinical staff involved in chronic disease management in cancer symptoms/diagnosis

Significant 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 Studyundertaken in 2013.

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