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1 in 3 pancreatic cancer patients need 3 or more GP visits before referral to a specialist

GP and patientA UK study of over 13,000 cancer patients has revealed that around one in three pancreatic cancer patients require three or more visits to their GP before they are referred to a specialist. And, as you would expect, the more GP visits patients had to make delayed their diagnosis. For pancreatic cancer patients who visited their GP more than five times, their diagnosis was delayed on average by more than three months.

Late diagnosis is one of the reasons why pancreatic cancer survival rates are lower than for other types of cancer.

In the study1, researchers analysed data from the Royal College of GPs (RCGP) National Audit of Cancer Diagnosis in Primary Care 2009-10 involving 13,035 patients and 18 different cancers. The report is the largest study yet into the primary care pathway from presentation to cancer diagnosis and involved one in seven GP practices in England.

Pancreatic cancer is one of the exceptions in the study as for most other cancers it was found that GPs refer patients in only two visits and for breast cancer patients only three per cent had to visit their GP  three or more times before being referred and 72 per cent required only one visit. The findings in this study, especially the patterns of variation by cancer, were very similar to those published in the 2010 Cancer Patient Experience Survey2.

One of the reasons that pancreatic cancer patients require more GP visits and suffer more delays in diagnosis is because the symptoms of pancreatic cancer can be confused with other, more benign conditions by both doctor and patient alike.

Ali Stunt, Chief Executive of Pancreatic Cancer Action said, “While it is encouraging to see that GPs are able to diagnose the majority of cancers within two visits, this study highlights the need for more work to be done to help GPs identify symptoms of the more difficult to diagnose cancers such as pancreatic cancer. We at Pancreatic Cancer Action have developed an online e-learning tool in association with the RCGP entitled ‘Diagnosing Pancreatic Cancer in Primary Care’ specifically for this purpose and we would encourage all GPs to take the module which is free and CPD accredited.

“We would also encourage patients who are experiencing symptoms suggestive of pancreatic cancer that are not normal for them,  are not going away or are getting worse to go to their doctors and tell them they are worried about pancreatic cancer. It is also important for patients to go back to their doctor if symptoms persist after that initial visit.”

Earlier diagnosis of pancreatic cancer will save lives. See our Pancreatic Cancer Symptoms Awareness Videos.

Footnotes:

  1. Lyratzopoulos et al., (2013) Measures of promptness of cancer diagnosis in primary care: secondary analysis of national audit data on patients with 18 common and rarer cancers. BJC 1-5 doi: 10.1038/bjc.2013.1  
  2.  Lyratzopoulos G, Neal RD, Barbiere JM, Rubin GP, Abel GA (2012) Variation in number of general practitioner consultations before hospital referral for cancer: findings from the 2010 National Cancer Patient Experience Survey in England. Lancet Oncol 13(4): 353–365  

4 Responses to “1 in 3 pancreatic cancer patients need 3 or more GP visits before referral to a specialist”

  1. I had at least 10 Gp visits before i was referred ….10 months later i got the devastating news that i had pancreatic cancer , already too late for surgery , it was wrapped around 2 veins . When is this going to change , earlier diagnosis is the only way to save lifes x

  2. Delay in diagnosis is not only at GP level.
    Many patients are misdiagnosed as GORD, IBS, gastritis etc. by gastroenterologists, general physicians, general surgeons too. Furthermore, radiologists also misinterpret CT scans and call tumours “focal pancreatitis” etc..

  3. Delay in diagnosis is not only at GP level.
    Many patients are misdiagnosed as GORD, IBS, gastritis etc. by gastroenterologists, general physicians, general surgeons too. Furthermore, radiologists also misinterpret CT scans and call tumours “focal pancreatitis” etc..

    • Ali Stunt says:

      Hi Graham,
      We agree and this is why we are currently re-writing our e-learning module for other clinicians including hospital doctors as the majority of patients will either be diagnosed in A&E or via other outpatient departments. Often there is delay when patients are initially referred to the wrong specialist or outpatients department. This module should be available in about 2-3 months time and will be hosted on the British Medical Journal (BMJ) website e-learning platform.

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The views expressed in this blog are the authors' own.