Delays in spotting the early signs and symptoms of cancer could be costing the lives of thousands of people in England and Wales every year.

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.

Source: NICE