The 3 cancers most challenging to diagnose in general practice
A study has found that certain cancers often take up to three or more general practice visits before a patient is referred to a specialist.
The research, published in this week’s Medical Journal of Australia, found pancreatic, prostate and multiple myeloma were the most likely to have non-specific symptoms and controversial timing of testing which made them harder to diagnose.
Professor Jon Emery together with Ms Karen Lacey and colleagues wrote: “With the exception of jaundice, which is a presenting symptom in only very few cases, the positive predictive value of other common symptoms of pancreatic cancer is very low.”
Other cancers such as breast cancer have more specific symptoms and higher community awareness.
34% of the patients included in the final analyses had visited the GP at least three times before referral to a specialist.
The study also examined the time between when symptoms were noticed and when the patient saw a specialist.
Patients with pancreatic and brain cancers were more likely to consult a GP several times before being referred, however it was generally less than three months between symptoms being noticed and specialist referral.
“This may be because of clearer and more rapid referral pathways for patients with these cancer types,” the authors wrote.
For a third of people with colon and prostate cancer, it took at least 3 months before they saw a hospital doctor, “possibly because patients or GPs erroneously attribute symptoms to more common, benign conditions; alternatively, limited access to gastroenterologists or urologists may be important.”
The authors say the research suggests that GPs may need to raise their level of suspicion for symptoms suggestive of certain cancers.
“Earlier diagnosis of these cancers may require different approaches to those that have been successful for breast cancer. Strategies should be investigated that reduce missed opportunities for diagnosing cancer earlier in general practice, including decision support tools, fast track referral pathways, and significant event audit,” they wrote.